CAJ | 학술논문

目的：探讨动态监测血乳酸﹑乳酸清除率及APACHEⅡ评分与感染性休克患者预后的相关性。方法分析2011年7月-2013年10月该院收治的58例感染性休克患者动脉血乳酸水平的动态变化,将患者按预后分为死亡组与存活组,通过比较两组患者乳酸水平,乳酸清除率及APACHEⅡ评分,并通过比较不同乳酸水平及乳酸清除率组患者的临床资料来评价患者的预后。结果存活组与死亡组相比较,在年龄(t=2.645,P<0.05)﹑初始乳酸(t=3.306,P<0.05)﹑24 h乳酸清除率(t=-6.755,P<0.05)﹑APACHEⅡ评分(t=5.538,P<0.05)方面差异有统计学意义。高乳酸清除率组和低乳酸清除率组比较,两组在APACHEⅡ评分及初始乳酸值方面差异无统计学意义,而在死亡人数(χ2=4.852,P<0.05)及年龄(t=2.093,P<0.05)方面差异有统计学意义。结论动态监测血乳酸是判断感染性休克患者病情严重程度的指标,乳酸清除率及APACHEⅡ评分与患者的预后关系密切,对于高乳酸患者应尽早治疗,改善器官灌注及组织缺氧状态。
목적：탐토동태감측혈유산﹑유산청제솔급APACHEⅡ평분여감염성휴극환자예후적상관성。방법분석2011년7월-2013년10월해원수치적58례감염성휴극환자동맥혈유산수평적동태변화,장환자안예후분위사망조여존활조,통과비교량조환자유산수평,유산청제솔급APACHEⅡ평분,병통과비교불동유산수평급유산청제솔조환자적림상자료래평개환자적예후。결과존활조여사망조상비교,재년령(t=2.645,P<0.05)﹑초시유산(t=3.306,P<0.05)﹑24 h유산청제솔(t=-6.755,P<0.05)﹑APACHEⅡ평분(t=5.538,P<0.05)방면차이유통계학의의。고유산청제솔조화저유산청제솔조비교,량조재APACHEⅡ평분급초시유산치방면차이무통계학의의,이재사망인수(χ2=4.852,P<0.05)급년령(t=2.093,P<0.05)방면차이유통계학의의。결론동태감측혈유산시판단감염성휴극환자병정엄중정도적지표,유산청제솔급APACHEⅡ평분여환자적예후관계밀절,대우고유산환자응진조치료,개선기관관주급조직결양상태。
Objective To discuss the relationship between dynamically monitoring blood lactate level, lactate clearance, Acute Physiology and Chronic Health Evaluation (APACHEⅡ) and the prognosis of patients with septic shock. Methods The dynamic changes of arterial blood lactate level of 58 cases with septic shock admitted in our hospital from July 2011 to October 2013 were analyzed. The patients were divided into the death group and the survival group. And the prognosis of the patients was evaluated by comparing blood lactate level, lactate clearance rate, APACHEⅡscore of the patients in the two groups, and the clinical data of patients with different blood lactate level and lactate clearance rate. Results The differences in age (t=2.645, P<0.05), initial lac-tate level (t=3.306, P<0.05) and 24 hours lactate clearance rate (t=-6.755, P<0.05) and APACHEⅡ (t=5.538, P<0.05) between the survival group and death group were statistically significant. The differences in number of deaths (χ2=4.852, P<0.05) and age (t=2.093, P<0.05) between patients with low lactate clearance rate group and those with high lactate clearance rate group were statis-tically significant, while the differences in APACHEⅡ and initial lactate level between the two groups were not. Conclusion Dy-namically monitoring the blood lactate level is an indicator for evaluating the condition of the patients with septic shock. Lactate clearance rate and APACHEⅡ are closely related to the prognosis of the patients with septic shock. Patients with high blood lac-tate level should be treated as soon as possible for improving the organ perfusion and tissue hypoxia.