重症创伤患者乳酸清除率、凝溶胶蛋白变化与其预后的关系  

Relationship between Lactate Clearance Rate,Gelsolin Change and Prognosis in Patients with Severe Trauma

作　　者：潘金龙 侯晓伟 王刚 PAN Jin-long;HOU Xiao-wei;WANG Gang(Department of Emergency,Staff Hospital of Henan Province,Zhengzhou 450002,China)

机构地区：[1]河南省职工医院急诊科,郑州450002

出　　处：《四川解剖学杂志》2023年第4期37-39,共3页Sichuan Journal of Anatomy

摘　　要：目的:研究重症创伤患者乳酸清除率、凝溶胶蛋白(GSN)变化与预后的关系.方法:选取2020年4月至2022年3月本院收治的96例重症创伤患者作为研究对象.根据随访1年里患者的预后情况,将其分为预后不良组(n=18)和预后良好组(n=78).分析影响重症创伤患者预后的危险因素;并分析乳酸清除率、CSN及急性生理与慢性健康评分(APACHE)Ⅱ评分与预后的相关性.结果:两组APACHEⅡ评分、D-二聚体(D-D)、纤维蛋白原(Fbg)、乳酸清除率及GSN比较,差异有统计学意义(P<0.05).行二元Logistic回归分析,结果显示APACHEⅡ评分、D-D、乳酸清除率及GSN是影响重症创伤患者预后的危险因素(P<0.05).经Pearson相关性分析显示,乳酸清除率、GSN与APACHEⅡ评分均呈负相关关系(P<0.05).结论:重症创伤患者若处于预后不良状况,机体乳酸清除率、GSN水平均下降,通过检测二者指标可有效评估重症创伤患者的预后情况.Objective:To study the relationship between lactate clearance rate,Gelsolin(GSN)change and prognosis in patients with severe trauma.Methods:Ninety-six patients with severe trauma admited to our hospital from April 2020 to March 2022 were selected in this study.According to the prognosis of the patients during the one-year follow-up,they were divided into poor prognosis group(n=18)and good prognosis group(n=78).The risk factors that affect the prognosis of patients with severe trauma were analyzed.And the relationship between lactate clearance rate,GSN,and the score of acute physiology and chronic health evaluation(APACHE)I were analyzed as well.Results:There were significant differences in APACHE II score,D-dimer(D-D),fibrinogen(Fbg),lactic acid clearance rate and CSN between two groups,with differences statistically significant(P<0.05).Binary Logistic regression analysis showed that APACHE II score,D-D,lactic acid clearance rate and GSN were risk factors affecting the prognosis of patients with severe trauma(P<0.05).Lactic acid clearance,GSN and APACHE II score were negatively correlated by Pearson correlation analysis(P<0.05).Conclusion:If the prognosis of patients with severe trauma is poor,both the lactate clearance rate and GSN level are decreased,the detection of both indexes can effectively evaluate the prognosis of patients with severe trauma.

关 键 词：重症创伤 乳酸清除率 凝溶胶蛋白 预后 

分 类 号：R64[医药卫生—外科学]