血清乳酸评估对危重患者预后的临床研究  

Clinical Study of Serum Lactate in Evaluating Prognosis of Critical Illness Patients

作　　者：宋婷[1] 杨敏婕[1] 胡弘[1] 徐思远[1] 胡祖鹏[1] 

机构地区：[1]复旦大学附属华山医院急诊科,上海200040

出　　处：《现代生物医学进展》2015年第23期4474-4476,共3页Progress in Modern Biomedicine

摘　　要：目的:研究血清乳酸评估对危重患者预后的意义,为后期临床诊断提供参考。方法:选取2012年3月—2014年4月我院收治的危重患者78例,对其血清乳酸进行评估,根据评估结果分为观察组与对比组,40例患者血清乳酸在监测过程中升高为观察组,38例患者血清乳酸监测持续正常为对比组。分析两组患者不良预后与临床变化,同时将观察组存活与死亡患者的血清乳酸监测情况进行评估。结果:观察组多器官功能不全者32例,休克31例,死亡22例;对比组多器官功能不全者15例,休克3例,死亡8例。观察组进入重症监护病房后,死亡组乳酸值为(6.21±2.51)mmol/L,乳酸峰值为(8.87±2.59)mmol/L,0.5天乳酸清除率为(23.21±18.54)mmol/L;存活组乳酸值为(2.21±1.89)mmol/L,乳酸峰值为(4.12±2.15)mmol/L,0.5天乳酸清除率为(44.78±26.58)mmol/L。结论:血清乳酸评估对危重患者预后具有十分重要的意义。Objective： To explore significance of serum lactic acid for evaluating prognosis in critical illness patients. Methods： 78 cases of critical illness patients from 2012 March to 2014 April were enrolled in this study to evaluate the serum lactic acid. According to the evaluation results, the patients were divided into observation group and contrast group： patients with increased serum lactic acid as the observation group（n=40）, and patients with serum lactate monitoring continuous as normal contrast group（n=38）. The prognosis and clinical changes of the two groups were analyzed. Furthermore, the serum lactate level was assessed for survival and death cases in the observation group. Results： Of all the observation group patients, 32 cases of multiple organ dysfunction, 31 cases of shock, and 22 cases of death. However, of the contrast group patient, 15 cases of multiple organ dysfunction, 3 cases of shock, and 8 cases died. After the patients from the observation group into the ICU, the lactic acid, lactic acid peak and 0.5 days of lactate clearance rate of death group was（6.21＋2.51） mmol/L,（8.87＋2.59） mmol/L and（23.21＋18.54） mmol/Lc whereas the lactic acid, lactic acid peak and 0.5 days of lactate clearance rate of survival was（2.21＋1.89） mmol/L,（4.12＋2.15） mmol/L, and（44.78＋26.58） mmol/L, respectively. Conclusion： The assessment of serum lactic acid has significance on the prognosis evaluation of critical illness patients.

关 键 词：血清乳酸评估 危重患者 预后意义 

分 类 号：R459.7[医药卫生—急诊医学]