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目的探讨动态监测血乳酸水平与危重症患者预后的关系,为重症患者的治疗提供理论依据。方法对128例危重症患者的血乳酸水平进行分析,并比较死亡组患者和存活组患者乳酸水平及不同乳酸水平患者不良预后情况。结果死亡组患者入院时乳酸水平、乳酸峰值、APACHEII评分等明显高于存活组患者,而24 h后乳酸清除率明显低于存活组,差异有统计学意义(P<0.01),严重乳酸酸中毒组APACHEII评分、休克、MODS和死亡比例均明显高于高乳酸组和乳酸中毒组,差异有统计学意义(P<0.01),经过Spearman相关性分析入院乳酸水平与APACHEII评分具有显著的正相关关系(P<0.01)。结论血乳酸水平可作为判断危重症患者病情和预后的重要监测指标。
Objective To investigate the relationship between the level of serum lactate and the prognosis of critically ill patients, and provide a theoretical basis for the treatment of critically ill patients. Methods Blood lactic acid levels in 128 critically ill patients were analyzed, and lactic acid levels in patients with death and those in survivors were compared with those in different lactic acid levels. Results The lactic acid level, lactic acid peak and APACHEII score of patients in the death group were significantly higher than those in the survivors group, but the lactic acid clearance rate was significantly lower than that of the surviving group after 24 hours (P <0.01). Serious lactic acidosis APACHEII score, shock, MODS and death rate were significantly higher than those in the group of high lactic acid and lactic acidosis (P <0.01). There was a significant positive correlation between the level of lactic acid and APACHEII score after Spearman correlation analysis (P <0.01). Conclusion The blood lactate level can be used as an important monitoring index to judge the condition and prognosis of critically ill patients.