动态监测血乳酸水平对创伤失血性休克患者预后的评估

Dynamic Observation of Blood Lactate Level in the Prognosis Judgment of Patients with Hemorrhagic Traumatic Shock

目的探讨动态监测血乳酸水平及乳酸清除率对创伤失血性休克患者预后的评估作用。方法将80例创伤失血性休克患者,以7d生存情况分为存活组47例,死亡组33例。测定两组患者入院时、复苏6h、12h、24h动脉血乳酸水平,计算6h、24h乳酸清除率,分析血乳酸水平、乳酸清除率与患者预后的关系。结果存活组各时间点血乳酸值均低于死亡组,6h、24h乳酸清除率高于死亡组,高乳酸持续时间少于死亡组,差异有统计学意义(P<0.05)。结论动态监测血乳酸水平对创伤失血性休克患者有重要意义,6h乳酸清除率可作为判断预后的重要指标。

Objective To discuss the valuation of blood lactic acid level and lactate clearance rate in the prognosis of patients with hemorrhagic traumatic shock. Methods 80 patients with hemorrhagic traumatic shock were divided into the survival group and death group according to their condition after 7 days of admission. There were 47 patients in the survival group and 33 patients in the death group. Their lactates were measured when admitted, and at 6 h, 12 h, and 24 h after shock. Lactate clearance rates were calculated after 6 h and 12 h. The relevance between lactate level, lactate clearance rate and the prognosis judgment of patients were evaluated. Results Compared with the death group, lactate levels were lower in the survival group at each time point; lactate clearance rates were significantly higher, while the high lactate duration were less in the survival group （P 〈0.05）. Conclusions Dynamic observation of lactate level is very important for the HTS patients. The 6 h and 24 h lactate clearance rate may be an important indicator in predicting the prognosis of patients with shock.