摘要
目的探讨乳酸清除率与急性一氧化碳中毒迟发性脑病患者预后的关系。方法选择急性重度一氧化碳中毒患者264例,根据有无发生中毒性脑病,分为对照组136例和病例组128例;所有入选者分别在治疗前、治疗6、24、48、72小时后均在不吸氧条件下抽取1ml动脉血,检测动脉血乳酸,同时计算乳酸清除率。比较两组患者的初始血乳酸水平、6、24、48、72小时乳酸清除率、清醒率以及并发症、病死率。结果病例组与对照组比较,初始血乳酸水平高、6、24、48小时乳酸清除率明显降低,而72小时乳酸清除率差异无统计学意义。病例组与对照组比较清醒率低,病死率高(P<0.05)。不同时间段乳酸清除率与相应时间段的清醒率呈线性关系。24小时乳酸清除率与迟发型脑病呈负相关(r=-0.479,P<0.05)。结论乳酸清除率有助于对急性一氧化碳中毒迟发性脑病患者严重程度的评估、指导治疗和判断预后。
Objective To study the relationship of lactate clearance rate and prognosis in patients with acute toxic encephalopathy after acute carbon monoxide poisoning.Methods 264 cases with acute severe carbon monoxide poisoning,according to whether the occurrence of toxic encephalopathy,were divided into case group 128 cases and control group 136 cases;All patients were examined respectively before treatment,6 h,24 h,48 h,72 h by 1 ml arterial blood oxygen test,detection of arterial blood lactic acid,while the calculation of lactate clearance rate was performed.The two groups of patients were compared with the initial level of blood lactic acid,6 h,24 h,48 h,72 h lactic acid clearance rate,rate of complication,mortality and sober.Results The initial blood lactate levels in the case group were higher than those in the control group,but 6 h,24 h,48 h lactic acid clearance rate in the case group was lower than that in the control group,while the 72 h lactate clearance rate showed no statistic significance between two groups.The sober rate of the case group was lower than that of the control group,but the mortality rate was higher than that of the control group（P〈0.05）.Different time of lactate clearance rate showed linear relationship with the sober rate.24 h lactate clearance rate and the delayed encephalopathy negatively correlated（r=-0.479,P〈0.05）.Conclusion Lactate clearance rate contributes to evaluate acute carbon monoxide poisoning encephalopathy patients,guiding therapy and judging prognosis.
出处
《临床荟萃》
CAS
2014年第3期324-326,共3页
Clinical Focus
基金
衡水市2010科研基金资助项目(10019A)
关键词
一氧化碳中毒
缺氧缺血
脑
乳酸
预后
carbon monoxide poisoning
hypoxia ischemia
brain
lactic acid
prognosis
