安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2015年
2期
149-150,151
,共3页
乳酸清除率%脓毒性休克,儿童%预后
乳痠清除率%膿毒性休剋,兒童%預後
유산청제솔%농독성휴극,인동%예후
Lactate clearance rate%Septic shock,Children%Prognosis
目的：评价6 h乳酸清除率与儿童脓毒性休克的关系。方法选取2009年11月至2013年7月安徽省立儿童医院儿童重症监护室脓毒性休克患儿45例，所有患儿入院后均按照2006年中华医学会儿科学分会急救学组制定的脓毒性休克诊疗方案进行早期目标化治疗，分别测定每例患儿复苏前及复苏后6h乳酸值，并计算6h乳酸清除率。按照预后将患儿分为存活组（n＝21）和死亡组（n＝24），评价6 h乳酸清除率与预后的关系。结果存活组复苏前及复苏后6 h乳酸值明显低于死亡组（4.25 mmol／L vs 6.87 mmol／L，P＜0.05）。存活组复苏后6 h乳酸清除率高于死亡组（21.12 mmoi／L）vs（－22.56 mmol／L）（P＜0.05）。结论脓毒性休克时动态监测血乳酸变化有助于对病情的评估，而6h血乳酸清除率是评估脓毒性休克患儿疗效及预后的快捷、有效指标。
目的：評價6 h乳痠清除率與兒童膿毒性休剋的關繫。方法選取2009年11月至2013年7月安徽省立兒童醫院兒童重癥鑑護室膿毒性休剋患兒45例，所有患兒入院後均按照2006年中華醫學會兒科學分會急救學組製定的膿毒性休剋診療方案進行早期目標化治療，分彆測定每例患兒複囌前及複囌後6h乳痠值，併計算6h乳痠清除率。按照預後將患兒分為存活組（n＝21）和死亡組（n＝24），評價6 h乳痠清除率與預後的關繫。結果存活組複囌前及複囌後6 h乳痠值明顯低于死亡組（4.25 mmol／L vs 6.87 mmol／L，P＜0.05）。存活組複囌後6 h乳痠清除率高于死亡組（21.12 mmoi／L）vs（－22.56 mmol／L）（P＜0.05）。結論膿毒性休剋時動態鑑測血乳痠變化有助于對病情的評估，而6h血乳痠清除率是評估膿毒性休剋患兒療效及預後的快捷、有效指標。
목적：평개6 h유산청제솔여인동농독성휴극적관계。방법선취2009년11월지2013년7월안휘성립인동의원인동중증감호실농독성휴극환인45례，소유환인입원후균안조2006년중화의학회인과학분회급구학조제정적농독성휴극진료방안진행조기목표화치료，분별측정매례환인복소전급복소후6h유산치，병계산6h유산청제솔。안조예후장환인분위존활조（n＝21）화사망조（n＝24），평개6 h유산청제솔여예후적관계。결과존활조복소전급복소후6 h유산치명현저우사망조（4.25 mmol／L vs 6.87 mmol／L，P＜0.05）。존활조복소후6 h유산청제솔고우사망조（21.12 mmoi／L）vs（－22.56 mmol／L）（P＜0.05）。결론농독성휴극시동태감측혈유산변화유조우대병정적평고，이6h혈유산청제솔시평고농독성휴극환인료효급예후적쾌첩、유효지표。
Objective To evaluate the relationship between 6-hour lactate clearance rate and prognosis of children with septic shock.Methods From Nov 2009 to Jul 2013,a total of 45 children with septic shock admitted in our hospital PICU were enrolled in the study.All the children were given early goal-directed therapy based on the diagnostic criteria and treatment for septic shock,established by the first-aid group of Society of Pediatrics of Chinese Medical Association in 2006.The blood lactate concentrations of all cases before resusci-tation and at 6 hours after resuscitation were tested,and then the 6-hour lactate clearance rate after resuscitation was calculated.All the chil-dren were divided into survival group (n=21)and non-survival group (n=24)according to their prognosis,and the relationship between lactate clearance rate and prognosis of children was assessed.Results The lactate concentrations before resuscitation and at 6 hours after re-suscitation in the survival group were significantly lower than those in the non-survival group (4.25 mmol/L vs 6.87 mmol/L,P<0.05). Conversely,the 6-hour lactate clearance rate in the survival group were significantly higher than that in the non-survival group (21.12 mmol/L vs -22.56 mmol/L,P<0.05 ).Conclusion It is definitely helpful to dynamically monitor the blood lactate concentration of children with septic shock for disease severity evaluation.The 6-hour lactate clearance rate could be used as a simple,practical,and effective indica-tor to assess the treatment efficacy and prognosis of patients.
