重症监护室中脓毒症患儿血乳酸水平和动脉血氧分压相关性分析.docVIP

重症监护室中脓毒症患儿血乳酸水平和动脉血氧分压相关性分析 　　 [摘要] 目的:回顾性分析脓毒症患儿血乳酸水平与动脉血氧分压(PaO2)之间的关系。方法：收集湖南省儿童医院2010年6月至10月因脓毒症进入重症监护病房(PICU)的383例患儿,入PICU时及入PICU 6 h动脉血氧分压值、乳酸水平及患儿预后的相关资料。根据动脉血氧分压值分为正常组、低氧血症但无呼吸衰竭组、呼吸衰竭组,比较各组患儿的血乳酸水平及预后；同时根据预后将383例患儿分为死亡组与存活组,比较其差异性。结果：呼吸衰竭组的血乳酸水平及病死率均明显高于低氧血症但无呼吸衰竭组和正常组(均P0.05)；入PICU 6 h时血乳酸水平存活组明显低于死亡组,而PaO2值存活组明显高于死亡组(P0.01)。结论：PICU脓毒症患儿血乳酸水平与动脉血氧分压值呈明显负相关。对于脓毒症患儿,积极纠正缺氧可改善其预后。 　　［关键词］ 脓毒症; 乳酸; 动脉血氧分压; 儿童 　　［中图分类号］ R723.12 ［文献标识码］ A ［文章编号］ 1671-7256(2011)02-0200-03 　　doi:10.3969/j.issn.1671-7256.2011．02.025 　　Relation between blood lactate level and PaO2 in pediatric patients 　　in ICU with sepsis 　　LIU Xiao, ZHU Yi-min, XU Zhi-yue 　　（The First Department of Critical Care Medicine, Hunan Children?s Hospital, Changsha 410007， China） 　　［Abstract］ Objective: To retrospectively analyze the relation between blood lactate level and PaO2 in sepsis pediatric patients. Methods: The data of 383 sepsis patients in PICU of Hunan children?s hospital were collected and observed during June 2010 to October 2010, including blood lactate level and PaO2 on admission and 6 hours later and the patients? prognosis. A total of 383 cases were divided into normal group,hyoxemia without respiratory failure group and respiratory failure group based on the PaO2. On the other hand, they were classified into low and high lactate clearance rate group, the prognosises between them were compared. Finally, they were divided into survival group and dead group, differences between them were analyzed. Results: The lactate level and the mortality was significantly higher in respiratory failure group than in normal group and non-respiratory failure group(P0.05); but after 6 hours in PICU, the lactate level in survival group was significantly lower and the PaO2 was significantly higher than that in dead group(P0.01).Conclusion: There is an obvious negative correlation between the lactate level of blood and the PaO2 in sepsis pediatric patients in PICU. Active correction of anoxia will