早期血乳酸清除率对感染性休克治疗的评估价值.docVIP

早期血乳酸清除率对感染性休克治疗的评估价值 　　[摘要] 目的 分析早期血乳酸清除率对感染性休克治疗的评估价值。方法 随机抽取该院2013年5月―2015年5月重症监护病房感染性休克患者80例，根据患者4周内是否死亡分为存活组（n=63）例和死亡组（n=17）例，患者入院后均全部进行早期目标化治疗（EGDT），记录和比较两组患者治疗前（T0）、治疗6 h后（T1）以及治疗24 h后（T2）血乳酸水平及清除率，并统计急性生理学和慢性健康状况评分系统 （APACHEⅡ） 评分。结果 两组患者T0时间的乳酸水平比较无明显差异（P0.05）；存活组患者T1和T2的血清水平显著低于死亡组（P0.05），血乳酸清除率显著高于死亡组（P0.05）；存活组APACHEⅡ评分显著低于死亡组（P0.05）。 结论 对于感染性休克患者，可将早期血乳酸水平和血乳酸清除率作为评估患者预后的指标。 　　[关键词] 早期血乳酸清除率；感染性休克；血乳酸清除水平；价值 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）11（b）-0049-02 　　[Abstract] Objective To evaluate the value of early blood lactate clearance in the treatment of septic shock. Methods 80 cases with septic shock admitted in the ICU of our hospital from May 2013 to May 2015 were divided into the survival group（n=63 cases） and the death group（n=17 cases） according to whether the patients died within four weeks after admission. All the patients were given early goal directed therapy（EGDT） after admission. The blood lactate level and blood lactate clearance of the two groups were recorded and compared before the treatment（T0）， 6h after the treatment（T1） and 24h after the treatment（T2）. And the acute physiology and chronic health evaluation scoring system scores of the two groups （APACHEⅡ） were counted. Results There was significant difference in the blood lactate level between the two groups at T0 （P0.05）. The serum levels of the survival group at T1 and T2 were much lower than those of the death group（P0.05）， blood lactate clearance rate of the survival group was significantly higher than that of the death group （P0.05）. The survival group had significantly lower APACHEⅡ scores than the death group（P0.05）. Conclusion For patients with septic shock， early blood lactate level and blood lactate clearance can be the indicators for assessing the prognosis. 　　[Key words] Early blood lactate clearance； Septic shock； Blood lactate clearance level； Value 　　严重感染和感染性休克是严重威胁人类健康的危重疾病，是由于各种原因导致机体发生严重感染继而引起组织灌注不足，器官代谢紊乱的一种临床综合症[1]。由于这种疾病病发较重，常常危及患者生命，因此，早期诊断和早期干预是改