CAJ | 학술논문

目的对行常规手术和损伤控制外科的严重创伤患者,检测其早期血乳酸浓度,了解两种手术方式对早期乳酸清除率的影响.方法选择严重创伤患者40例,依据所采取的手术方式不同分为常规手术组(对照组)和损伤控制外科组(控制组),每组20例.记录患者入院时的急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)、入院时和入院后6h的血乳酸浓度,计算早期乳酸清除率.结果控制组入院后6h血乳酸浓度明显低于对照组[(3.5±1.1) mmol/L比(4.2±1.4) mmol/L,P＜0.05],早期乳酸清除率明显高于对照组[(24.6±6.3)％比(11.4±5.3)％,P＜0.05].结论严重创伤患者行损伤控制外科有利于早期乳酸的清除,维持机体内环境稳定,是提高严重创伤救治成功率的关键.
목적 대행상규수술화손상공제외과적엄중창상환자,검측기조기혈유산농도,료해량충수술방식대조기유산청제솔적영향.방법 선택엄중창상환자40례,의거소채취적수술방식불동분위상규수술조(대조조)화손상공제외과조(공제조),매조20례.기록환자입원시적급성생리화만성건강상황평분Ⅱ(APACHEⅡ)、입원시화입원후6h적혈유산농도,계산조기유산청제솔.결과 공제조입원후6h혈유산농도명현저우대조조[(3.5±1.1) mmol/L비(4.2±1.4) mmol/L,P＜0.05],조기유산청제솔명현고우대조조[(24.6±6.3)％비(11.4±5.3)％,P＜0.05].결론 엄중창상환자행손상공제외과유리우조기유산적청제,유지궤체내배경은정,시제고엄중창상구치성공솔적관건.
Objective To monitor the early blood lactic acid concentration of patients with severe trauma who have been experienced routine surgery or damage control surgery,and explore the influence of surgical methods for the early lactate clearance rate.Methods Selected 40 patients with severe trauma,they were divided into two groups with 20 cases each in accordance with the adopted operation mode,reference group by damage control surgery,and control group by routine surgery.Recorded acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) in patients after admission,blood lactic acid concentration at 6 h after admission and admission,calculated the early lactate clearance rate.Results In reference group,blood lactic acid concentration at 6 h after admission was significantly lower than that in control group [ (3.5 ± 1.1 )mmol/L vs.(4.2 ± 1.4) mmol/L,P＜ 0.05 ],early lactate clearance rate was higher than that in control group [ (24.6 ± 6.3 )％ vs.( 11.4 ± 5.3 )％,P＜ 0.05 ].Conclusions Damage control surgery in patients with severe trauma in favour of the early removal of lactic acid,maintaining the homeostasis of the organism,is the key to improve the achievement ratio of treatment with severe trauma.