早期乳酸清除率、氧合指数对重症肺炎合并休克患者预后的评估作用  

Evaluation of early lactate clearance rate and oxygenation index on the prognosis of patients with severe pneumonia combined with shock

作　　者：刘汉冕[1] 杨日焰[1] 陈杏波[1] 凌云[1] 叶初阳[1] 瞿嵘[1] 

机构地区：[1]广东省惠州中心人民医院重症医学科,广东惠州516001

出　　处：《中国医药科学》2016年第13期199-202,共4页China Medicine And Pharmacy

基　　金：广东省惠州市科技计划项目(2015Y017)

摘　　要：目的分析早期乳酸清除率、氧合指数对重症肺炎合并休克患者预后的评估作用。方法选取2014年1月-2015年12月期间我院收治ICU重症肺炎患者40例。将患者按照治疗结果分为存活组和死亡组,比较两组患者的氧合指数、初始血乳酸水平以及6h乳酸清除率、APACHEⅡ评分。按照6h乳酸清除率的高低将超过10%患者分为高乳酸清除率组和小于或等于10%分为低乳酸清除率组,对两组的6h血乳酸水平、APACHEⅡ评分以及治疗28d后死亡率以及呼吸衰竭发生率进行比较。结果存活组与死亡组患者初始血乳酸差异无统计学意义（P〉0.05）,APACHEⅡ评分、氧合指数以及血乳酸清除率差异有统计学意义（P〈0.05）。高乳酸清除率组与低乳酸清除率组患者初始血乳酸以及APACHEⅡ评分差异无统计学意义;两组患者28d后死亡率、发生率差异有统计学意义（P〈0.05）。结论乳酸清除率、氧合指数对重症肺炎合并休克患者预后具有的评估作用,值得深入研究与推广应用。Objective To observe and analyze the evaluation of early lactate clearance rate and oxygenation index on the prognosis of patients with severe pneumonia combined with shock. Methods 40 cases of patients with severe pneumonia cured in ICU of our hospital from January 2014 to December 2015 were selected and divided into survival group and death group according to the results of treatment. Oxygenation index, initial blood lactate level and 6 hours lactate clearance rate, APACHE Ⅱ score of the two groups were compared. According to the level of 6 hours lactate clearance rate, patients with 6 hours lactate clearance rate more than 10% were divided into high lactate clearance rate group, and patients with 6 hours lactate clearance rate less than or equal to 10% were divided into low lactate clearance rate group. 6 hours blood lactate level, APACHE Ⅱ score, mortality rate and incidence of respiratory failure after treatment for 28 days of the two groups were compared. Results There was no significant difference in the initial blood lactate between the survival group and death group. The differences of APACHE Ⅱ score, oxygenation index and lactate clearance rate were statistically significant（P〈0.05）. There was no significant difference in the initial blood lactate and APACHE Ⅱ score between the high lactate clearance rate group and low lactate clearance rate group. Mortality rate and incidence of respiratory failure after treatment for 28 days of the two groups were statistically significant（P〈0.05）. Conclusion The evaluation of early lactate clearance rate and oxygenation index on the prognosis of patients with severe pneumonia combined with shock is worthy of further research and popularization and application.

关 键 词：乳酸清除率 氧合指数 重症肺炎 休克 评估作用 

分 类 号：R563.1[医药卫生—呼吸系统]