安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
ACTA UNIVERSITY MEDICINALIS ANHUI
2014年
2期
251-253,257
,共4页
重症脓毒症%血乳酸%6h乳酸清除率%连续性血液净化%预后
重癥膿毒癥%血乳痠%6h乳痠清除率%連續性血液淨化%預後
중증농독증%혈유산%6h유산청제솔%련속성혈액정화%예후
severe sepsis%blood lactic acid%6h lactic clearance rate%continuous blood purification%prognosis
目的探讨连续性血液净化对重症脓毒症患者的血乳酸水平及6h乳酸清除率的影响。方法本研究为前瞻性随机对照研究。48例重症脓毒症患者随机分为常规治疗组(对照组)和连续性血液净化组( CBP组),入重症医学科( ICU)时检测其动脉血乳酸水平,并在6、24、48、72 h时间点复检,计算出该患者6h血乳酸清除率；并记录相应时间点的急性生理和慢性健康状态评分( APACHEⅡ评分)。比较两组间血乳酸水平、6 h 乳酸清除率、APACHEⅡ评分的变化；比较两组患者住ICU时间以及28 d病死率。结果与对照组比较,CBP组患者各时间点的APACHEⅡ评分和血乳酸水平降低明显,6 h乳酸清除率明显增加,ICU住院时间明显缩短,差异均有统计学意义( P<0.05)；28 d病死率有降低趋势,但差异无统计学意义。结论重症脓毒症患者, CBP治疗能有效降低血乳酸水平,减轻病情的严重程度,缩短ICU住院时间。
目的探討連續性血液淨化對重癥膿毒癥患者的血乳痠水平及6h乳痠清除率的影響。方法本研究為前瞻性隨機對照研究。48例重癥膿毒癥患者隨機分為常規治療組(對照組)和連續性血液淨化組( CBP組),入重癥醫學科( ICU)時檢測其動脈血乳痠水平,併在6、24、48、72 h時間點複檢,計算齣該患者6h血乳痠清除率；併記錄相應時間點的急性生理和慢性健康狀態評分( APACHEⅡ評分)。比較兩組間血乳痠水平、6 h 乳痠清除率、APACHEⅡ評分的變化；比較兩組患者住ICU時間以及28 d病死率。結果與對照組比較,CBP組患者各時間點的APACHEⅡ評分和血乳痠水平降低明顯,6 h乳痠清除率明顯增加,ICU住院時間明顯縮短,差異均有統計學意義( P<0.05)；28 d病死率有降低趨勢,但差異無統計學意義。結論重癥膿毒癥患者, CBP治療能有效降低血乳痠水平,減輕病情的嚴重程度,縮短ICU住院時間。
목적탐토련속성혈액정화대중증농독증환자적혈유산수평급6h유산청제솔적영향。방법본연구위전첨성수궤대조연구。48례중증농독증환자수궤분위상규치료조(대조조)화련속성혈액정화조( CBP조),입중증의학과( ICU)시검측기동맥혈유산수평,병재6、24、48、72 h시간점복검,계산출해환자6h혈유산청제솔；병기록상응시간점적급성생리화만성건강상태평분( APACHEⅡ평분)。비교량조간혈유산수평、6 h 유산청제솔、APACHEⅡ평분적변화；비교량조환자주ICU시간이급28 d병사솔。결과여대조조비교,CBP조환자각시간점적APACHEⅡ평분화혈유산수평강저명현,6 h유산청제솔명현증가,ICU주원시간명현축단,차이균유통계학의의( P<0.05)；28 d병사솔유강저추세,단차이무통계학의의。결론중증농독증환자, CBP치료능유효강저혈유산수평,감경병정적엄중정도,축단ICU주원시간。
Objective To investigate the effect of continuous blood purification ( CBP) on the level of blood lactic acid and 6 h lactic clearance in the patients with severe sepsis. Methods 48 patients with severe sepsis were cho-sen in ICU, and they were randomly divided into two groups: control group ( n=20 ) and CBP group ( n=28 ) . Their arterial blood lactic acid level was tested on admission and was retested 6, 24, 48 and 72 h after treatment. The patients’6 h blood lactic clearance rate and the corresponding APACHEIIscore were calculated. The level of arterial blood lactic acid and the score of APACHE IIwere compared at different time. 6 h blood lactic clearance, the period of stay in ICU and the 28-days mortality were compared too. Results The level of lactic acid and the score of APACHE II after 24 h were lower in CBP group, and the period of stay in ICU was shorter in CBP group than that in control group at different time ( P<0.05 ) . 6 h blood lactic clearance was higher than that in control group (P<0.05). Moreover, the 28-days mortality had no significant difference in CBP group. Conclusion The CBP plays an important role in clearing the blood lactic acid and it can reduce the severity of the sepsis as well as shorten the period of stay in ICU.
