心肺复苏患者的临床预后与乳酸动态监测和凝血机制的相关性研究.docxVIP

心肺复苏患者的临床预后与乳酸动态监测和凝血机制的相 关性研究 DOI： 10.7504/nk2016010203 屮图分类号：R587.1 文献标识码：A 摘要：目的研究心肺复苏后患者血乳酸、凝血机制与APACHE II评分的关系, 分析动态血乳酸、凝血机制对复苏后患者预后的影响。方法 选取2014年8月 -2015年12月收治的40例心肺复苏后患者资料，按预后分为生存组与死亡组。 回顾两组患者在心帅复苏后凝血机制的水平及在自主循环恢复后Oh、2h、12h、 24h血乳酸水平，并据APACHE II评分，分组比较上述指标，分析患者的预后与 血乳酸及凝血机制的关系。结果 生存组自主循环恢复后2h、12h、24h血乳酸 低于死亡组，有统计学意义(Plt;0.05),复苏即刻生存组血乳酸与死亡组比较， 无统计学意义((Pgt;0.05)；生存组血浆凝血酶原时间、活化部分凝血激酶时间、 凝血酶时间低于死亡组患者，有统计学意义((Plt;0.05)；生存组纤维蛋白原与死 亡组比较，无统计学意义((Pgt;0.05)；且APACHE II评分越高，乳酸、PT、APTT、 TT越高。结论血乳酸动态监测及凝血机制检测，二者联合是预测心肺复苏后 患者预后的敏感指标。 关键词：心肺复苏 乳酸、凝血功能、APACHE II评分 预后 Relati on ship betwee n clin ical prog nosis and dyn amic mon itori ng of lactic acid and blood coagulati on function in patie nts with cardiopulm on ary resuscitati on Wangbingjin Guizhou provinee peoples hospital emergency department,550002, china. Tel:Email:yangxinyu820331@ 163.com? zhou hou rong Guizhou provinee peoples hospital emergency department. [Absstract ] Objective To study cardiopulm on ary resuscitatio n, blood lactic acid , coagulation mechanisms and APACHE II score. Analysis dynamic blood lactic acid, coagulatio n mecha nism of in flue nee on the prog nosis of patie nts with post Resustio n. Methods in August 2014 and 2015 December 40 patie nts after cardiopulm on ary resuscitatio n were, accordi ng to the pro gnosis of divided into survival group and death group. Review of the two groups of patie nts after cardiopulm on ary resuscitation levels of coagulation mechanism and after restoration of spontaneous circulation in Oh, 2h, 12h, 24h blood lactic acid level and according to APACHE II score, these in dexes betwee n packet. An alysis patie nts prog nosis and blood lactic acid and blood coagulat -ion mechanism . Results the survival group of spontaneous circulation restoration after 2h, 12h, 24h blood lactate below death group, statistical sign讦icance (Plt;0.05), immediate resuscitation survival group blood lactate and death group, no statistical significanee (Pgt;0.05); survival g