血清乳酸水平与外伤性迟发性颅内血肿的相关性研究

Study on correlation between delayed traumatic inintracranial hematoma and serum lactic acid level

目的：评估血清乳酸水平与颅脑损伤发生外伤性迟发性颅内血肿（DTIH）的关系。方法选择我院2012年6月-2015年1月收治的脑外伤患者160例，按ISS分值分成重伤组（16～25分）和严重伤组（≥25分），并根据预后分为DTIH组和非DTIH组。于入院时、6h和24h检测动脉血乳酸水平，计算乳酸清除率。结果严重伤组入院时、6h、24h血乳酸水平及DTIH发生率均明显高于重伤组，差异均有统计学意义（P＜0．05）；严重伤组12h乳酸清除率明显低于重伤组，差异有统计学意义（P＜0．05）。DTIH组入院时、6h、24h血乳酸水平及ISS评分均明显高于非DTIH组，差异均有统计学意义（P＜0．05）；DTIH组6h、12h乳酸清除率明显低于非DTIH组，差异均有统计学意义（P＜0．05）。入院时、6h、24h血乳酸水平与DTIH发生均呈正相关（P＜0．05）。结论早期动脉血乳酸水平与颅脑损伤患者DTIH的发生密切相关，对评估颅脑损伤严重程度及判断DTIH发生风险具有重要意义。

Objective To evaluate the correlation between serum lactic acid level and delayed traumatic intracranial hematoma （DTIH）in the patients of brain injury.Methods 160 patients of traumatic brain injury who were admitted into our hospital from 2012 June-2015 year in January were observed.according to ISS scores,they were divided into in-jury groups（16- 25）and severe injury group（≥ 25）,and according to the prognosis,they were divided into DTIH group and non DTIH group.Arterial blood lactate was measured at 0 h,6 h and 24 h,later 6 h and 24 h lactate clearance rate was calculated.Results 0 h,6 h,24 h serum lactic acid level and the incidence of DTIH in severe injury group were significantly higher than those in injury group,the differences were statistically significant （P 〈0.05）;12h lactic acid clearance rate in severe injury group was significantly lower than that in injury group,the difference was statistically significant （P 〈0.05）.0 h,6 h,24 h serum lactic acid level and ISS score in DTIH group were significantly higher than those in non DTIH group,the differences were statistically significant （P 〈0.05）;6 h and 12 h lactic acid clearance rate in DTIH group was significantly lower than that in non DTIH group,the difference was statistically significant （P 〈0.05）.There were significant correlation between 0h,6h,24h serum lactic acid level and DTIH （P 〈0.05）.Conclusion There were significant correlation between early arterial blood lactate levels and DTIH in patients of traumatic brain injury,and it is important to evaluate the severity and risk of DTIH in patients of brain injury.