CAJ | 학술논문

目的：探讨早期血乳酸及乳酸清除率在小儿脓毒症不同病情阶段中的动态变化，以期尽早干预，同时为判断预后提供理论依据。方法选取2013年12月～2014年9月我院PICU脓毒症患儿40例为观察对象，其中脓毒症组15例，严重脓毒症组15例，MODS组10例。对入选患儿应用危重病例评分法进行危重症评分（PCIS），检测各组0、1h、6h、12h血乳酸，并计算血乳酸清除率。结果（1）脓毒症、严重脓毒症、MODS患儿早期血乳酸浓度比较差异有统计学意义（P＜0.05）；（2）严重脓毒症与MODS患儿1h血乳酸清除率比较，差异无统计学意义（P＞0.05），两组患儿6h血乳酸清除率相比较，差异具有统计学意义（P＜0.05）；（3）严重脓毒症及MODS患儿PCIS与血乳酸浓度差异有统计学意义（P＜0.05），PCIS与血乳酸清除率有高度相关性（P＜0.01）。结论早期血乳酸及血乳酸清除率对评价脓毒症患儿病情和预测预后有指导作用。
목적：탐토조기혈유산급유산청제솔재소인농독증불동병정계단중적동태변화，이기진조간예，동시위판단예후제공이론의거。방법선취2013년12월～2014년9월아원PICU농독증환인40례위관찰대상，기중농독증조15례，엄중농독증조15례，MODS조10례。대입선환인응용위중병례평분법진행위중증평분（PCIS），검측각조0、1h、6h、12h혈유산，병계산혈유산청제솔。결과（1）농독증、엄중농독증、MODS환인조기혈유산농도비교차이유통계학의의（P＜0.05）；（2）엄중농독증여MODS환인1h혈유산청제솔비교，차이무통계학의의（P＞0.05），량조환인6h혈유산청제솔상비교，차이구유통계학의의（P＜0.05）；（3）엄중농독증급MODS환인PCIS여혈유산농도차이유통계학의의（P＜0.05），PCIS여혈유산청제솔유고도상관성（P＜0.01）。결론조기혈유산급혈유산청제솔대평개농독증환인병정화예측예후유지도작용。
Objective To explore the dynamic change of blood lactic acid and its elimination rate at different stage of pediatric sepsis,by which,in order to intervening early and provide theoretical basis for predicting prognosis. Methods 40 children with sepsis in PICU of our hospital during December 2013 to September 2014 were chosen as objects of observation.There were 15 cases in the sepsis group and serious sepsis group respectively,and 10 cases in the MODS group.The chosen children were taken for severity score used pediatric critical illness score (PCIS).The concentrations of the blood lactic acid of children in the three groups were determined respectively at 0h,1h,6h and 12h,according to which the elimination rate of blood lactic acid were calculated. Results (1)The concentrations of blood lactic acid had significant difference (P<0.05) at the early stage between the sepsis group,serious sepsis group and MODS group.(2)The difference of the elimination rate of blood lactic acid between the serious sepsis group and MODS group was not significant (P>0.05) at 1h,but significant(P<0.05)at 6h.(3)There were significant correlation (P < 0.05) between the PCIS and the concentration of blood lactic acid and high correlation (P < 0.01) between the PCIS and the elimination rate of blood lactic acid of children in the serious sepsis group and MODS group. Conclusion The concentration and elimination rate of blood lactic acid at the early stage has the role of guiding estimate the conditions of children with sepsis and predict prognosis.