小儿脓毒症早期血乳酸及乳酸清除率的变化及临床价值  

Changes and clinical value of blood lactic acid and lactic acid clearance rate in early stage of sepsis in children

作　　者：薛坤[1] 牟春燕 李小敏[1] XUE Kun;MOU Chunyan;LI Xiaomin(Baoji Maternal and Child Health Hospital/Baoji Children's Hospital/Baoji City Women's and Children's Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市妇幼保健院/宝鸡市儿童医院/宝鸡市妇儿医院,陕西宝鸡721000

出　　处：《临床医学研究与实践》2020年第31期64-66,共3页Clinical Research and Practice

基　　金：宝鸡市卫生和计划生育局科研课题(No.2017-34)。

摘　　要：目的探讨小儿脓毒症早期血乳酸及乳酸清除率的变化及临床价值。方法回顾性分析2017年5月至2020年4月收诊的120例脓毒症患儿的临床资料,按照血乳酸水平不同将其分为A组(34例,血乳酸正常)、B组(50例,血乳酸轻度增高)、C组(36例,血乳酸重度增高),同时按照乳酸清除率不同将其分为D组(32例,轻度乳酸清除率)、E组(45例,中度乳酸清除率)、F组(43例,高度乳酸清除率)。比较各组患儿的临床状况与预后情况。结果A组的住院天数短于B、C组,PCIS评分高于B、C组,CRP水平低于B、C组(P<0.05);A组的机械通气、MODS、休克、死亡患儿占比低于B、C组。B组住院天数短于C组,PCIS评分高于C组,CRP水平及机械通气、MODS、休克、死亡患儿占比低于C组(P<0.05)。D组的住院天数长于E、F组,PCIS评分低于E、F组,CRP水平及机械通气、MODS、休克、死亡患儿占比高于E、F组(P<0.05)。E组的住院天数长于F组,PCIS评分低于F组,CRP水平高于F组(P<0.05);E组的机械通气、MODS、休克、死亡患儿占比高于F组。结论随着血乳酸水平的持续升高,脓毒症患儿的预后相应越差,而乳酸清除率的结果则相反,临床可将上述指标作为评判脓毒症患儿临床状况与预后的标准,以为后续治疗夯实基础。Objective To investigate the changes and clinical value of blood lactic acid and lactic acid clearance rate in early stage of sepsis in children.Methods The clinical data of 120 children with sepsis treated from May 2017 to April 2020 were retrospectively analyzed.The children were divided into group A(34 cases,normal blood lactic acid),group B(50 cases,slightly increased blood lactic acid),and group C(36 cases,severe increased of blood lactic acid)according to different blood lactic acid levels.According to the different lactic acid clearance rate,the children were divided into group D(32 cases,mild lacti cacid clearance rate)and group E(45 cases,moderate lacti cacid clearance rate),group F(43 cases,high lactic acid clearance rate).The clinical status and prognosis of children in each group were compared.Results The length of hospital stay in the group A were shorter than that in the group B and group C,the PCIS score were higher than that in the group B and group C,and the CRP level was lower than that in the group B and group C(P<0.05);the proportions of children with mechanical ventilation,MODS,shock and death in the group A were lower than those in the group B and group C.The length of hospital stay in the group B was shorter than that in the group C,and the PCIS score was higher than that in the group C,the CRP level and the proportions of children with mechanical ventilation,MODS,shock and death were lower than those in the group C(P<0.05).The length of hospital stay in the group D were longer than that in the group E and group F,and the PCIS score were lower than that in the group E and group F,the CRP level and proportions of children with mechanical ventilation,MODS,shock and death were higher than those in the group E and group F(P<0.05).The length of hospital stay in the group E was longer than that in the group F,the PCIS score was lower than that in the group F,and the CRP level was higher than that in the group F(P<0.05);the proportions of children with mechanical ventilation,MODS,shock and death i

关 键 词：乳酸清除率 血乳酸 脓毒症 小儿 

分 类 号：R720.597[医药卫生—急诊医学]