早期血乳酸清除率对多发伤休克患者病情及预后评估的临床价值  

Early blood lactate clearance rate in assessment of the severity and prognosis of multiple trauma patients with chock

作　　者：张雪锋[1] 胡海敏[1] 钱利华[1] 殷瑞[1] 李婷[1] 

机构地区：[1]海盐县人民医院重症医学科,314300

出　　处：《浙江医学》2012年第20期1673-1674,1676,共3页Zhejiang Medical Journal

摘　　要：目的探讨早期血乳酸清除率对多发伤休克患者病情严重程度及预后的评估价值。方法对69例多发伤休克患者入院后立即抽取动脉血作血气分析检查，入院后6h和24h复检动脉血气分析，计算乳酸清除率。根据预后和血气分析结果将患者分为存活组和死亡组，高乳酸清除率组和低乳酸清除率组。对各组乳酸值、乳酸清除率和多器官功能障碍综合征（MODS）发生率、病死率等相关指标进行比较。结果6h和24h乳酸清除率：存活组分别为（31±15）％和（51±19）％，死亡组分别为（15±8）％和（11±7）％（P〈0．01）；MODS发生率和病死率：高乳酸清除率组分别为212％和617％，低乳酸清除率组分别为33．6％和50．5％（P〈0．01）。结论多发伤休克患者入院后应常规监测血乳酸清除率，对评估病情、判断预后有积极的临床意义。Objective To assess the severity and prognosis of multiple trauma patients with shock by early blood lactate clearance rate. Methods Arterial blood samples were collected from Sixty nine multiple trauma patients with shock immediately, and 6h and 24h after admission to Critical Care Medicine for blood gas analysis, the lactate clearance rate was calculated, The correlation of lactate clearance rate with the clinical outcome of the patients was analyzed. Results The 6h, 24h lactate clear- ance rates in survival group and fatal group were 31 ± 15%, 51 ± 19%, and 15 ± 8%, 11 ± 7% respectively （P〈0.01）. The incidence and mortality rate of multiple organ dysfunction syndrome （MODS） in high lactate clearance rate group and low lactate clearance rate group were 2.2%, 6.7%, and 33.6%, 50.5% respectively （P〈0.01）. Conclusion Multiple trauma patients with shock should undergo regular monitoring of blood lactate clearance rate after admission for assessment of the severity and the prognosis.

关 键 词：早期乳酸清除率 多发伤 休克 预后 

分 类 号：R195.1[医药卫生—卫生统计学]