摘要
目的:探讨ICU重症伴休克患者动脉血乳酸水平监测的临床意义。方法:选择2012年6月-2014年6月本院ICU收治的重症伴休克患者58例,患者入ICU后进行常规救治,并监测血乳酸水平,根据患者预后情况分为存活组和死亡组,观察比较两组各乳酸指标(主要包括入ICU血乳酸值、乳酸峰值、乳酸清除率等);全部患者根据6 h乳酸清除率分为低清除率组和高清除率组,观察两组患者APACHEⅡ评分、多脏器功能障碍综合征及病死情况。结果:死亡组患者入ICU血乳酸值、乳酸峰值明显高于存活组,6、24 h乳酸清除率明显低于存活组,差异均有统计学意义(P<0.05)。以6 h乳酸清除率分组,低清除率组APACHEⅡ评分、多器官功能障碍发生率、病死率均明显高于高清除率组,差异有统计学意义(P<0.05)。结论:重症患者血乳酸水平与预后有密切关系,血乳酸水平监测对判定病情、指导治疗、评价预后有积极作用。
Objective： To investigate the significance of arterial blood lactic acid monitoring in critical patients with shock in ICU. Method： 58 critical patients with shock admitted ICU from June 2012 to June 2014 were selected, they were given routine treatment, and then given arterial blood lactic acid monitoring. All the patients were divided into survival group and death group according to the prognosis, the lactic acid index （ including the admitting ICU blood lactic acid, lactic acid peak, lactic acid clearance rate, etc. ） was observed and compared. All the patients were divided into low and high clearance rate group according to 6 h lactate clearance rate, the APACHE Ⅱ score, multiple organ dyshmction syndrome （ MODS ） and fatality were observed. Result： The admitting ICU blood lactic acid, lactic acid peak of the death group was significantly higher than that of the survival group , and 6, 24 h lactic acid clearance rate was significantly lower than that of the survival group, the differences were statistically significant （ P〈0.05 ） . According to 6 h lactic acid clearance rate, the APACHE Ⅱ score, MODS incidence and mortality of low clearance rate group was significantly higher than that of high clearance rate group, the difference was statistically significant （P〈0.05 ） . Conclusion： The arterial blood lactic acid of critical patients is closely interrelated with prognosis, arterial blood lactic acid monitoring has a positive effect for condition judgment, treatment guiding, prognosis evaluation.
出处
《中国医学创新》
CAS
2015年第22期151-153,共3页
Medical Innovation of China
