心脏手术后乳酸降钙素原与预后的-现代临床医学.docVIP

PAGE PAGE 3 2015-10-11 完成编辑加工 2016-02 2016-2-29，主任加工 乳酸与降钙素原在体外循环术后评估中的应用 潘 旭，李 强 （重庆医科大学附属第一医院，重庆 400016） [摘要]目的：探讨乳酸、降钙素原在体外循环手术后预后评估中的价值。方法：以我院2013年12月至2015年3月收治的186例心脏病患者为研究对象，收集患者术后0 h、2 h、6 h、12 h、24 h、48 h和72 h不同时间点检测乳酸水平及术后第1天、第2天、第3天、第5天检测降钙素原水平，统计分析乳酸及降钙素原与患者预后之间的关系。结果：单因素分析发现术后乳酸及降钙素原的最高值均与患者体外循环术后的意外事件呈正相关，在多因素分析中也得到了证实，且与乳酸的相关性更强。结论：乳酸及降钙素原可作为体外循环术后患者的有效监测指标，对患者的术后病情变化有一定的评估价值。 [关键词]乳酸；降钙素原；体外循环；预后；评估 [中图分类号]R654.1 [文献标志码]A DOI:10.11851/j.issn.1673-1557.2016.02.0 Prognostic Value of Lactate and Procalcitonin for Patients Received Extracorporeal Circulation Operation PAN Xu, LI Qiang(The First Affiliated Hospital of Chongqing Medical University,Chongqing [Abstract]Objective:To explore the prognostic value of lactate and procalcitonin in patients after extracorporeal circulation operation.Method:Collected 186 cases of patients between December 2013 and March 2015 above the age of 18，recorded the lactate level in 0 h, 2 h,6 h,12 h,24 h,48 h and 72 h postoperatively and the procalcitonin level in 1,2,3,5 days postoperatively,then used statistical analysis method to explore the relationship between them and prognosis of patients.Result:According to the single factor analysis, postoperative lactate and procalcitonin were positively correlated with the the complications of patients, it was also comfirmed in multiple factors analysis,the correlation of lactate is stronger than other.Conclusion:Lactate and procalcitonin can be used as the effective monitoring indicators of postoperative patients after cardiopulmonary bypass, Lactate and procalcitonin have certain value of evaluation about the patients’postoperative condition changes. [Keywords]lactate;procalcitonin;extracorporeal circulation;prognosis;assessment 随着心脏疾病的发病率越来越高，体外循环心脏手术也越来越多。作为体外循环术后患者，由于术前手术时间长、创伤大、手术操作复杂、主动脉阻断时间长等情况，术后容易引发全身组织损伤、多器官功能受损，导致预后不良。作为心外科的医生，手术成功只是第一步，及时发现术后的病情变化并尽早干预，减少并发症，往往对患者的预后起着重要的作用。在心外科的长期发展中，希望可以找到合适的指标来判断患者的预后，及时发现问题，解决问题。乳酸是目前体外循环术中、术后判断病情、指导处理的重要指标 ADDI