摘要目的:评价乳酸清除率目标指导治疗对严重感染和感染性休克的治疗效果。方法:选择符合严重感染和感染性休克诊断标准的患者50例,随机分为试验组25例采用乳酸清除率目标指导治疗,对照组25例采用早期目标指导治疗。结果:治疗组28 d病死率明显低于对照组(60% vs 32%)。结论:乳酸清除率目标指导治疗有益于严重感染和感染性休克患者。
1Rivers E P, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock[J]. N Engl J Med, 2001,345 (116) : 1368.
2Angus D C, Linde-Zwirble W T, Lidieker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care [J]. Crit Care Med, 2001, 29(7) : 1303-1310.
3俞森洋.危重病监护治疗学[M].北京：北京医科大学、中国协和医科大学联合出版社,1998.67.
4Singhal R, Coghill J E, Guy A, et al. Serum lactate and base deficit as predictors of mortality after ruptured abdominal aortic aneurysm repair [J]. Eur J Vasc Endovasc Surg, 2005,30(3): 263.
5Boekstegers P P, Weidenher T, Kaspner, et al. Skeletal muscle partial pressure of oxygeninpatients with sepsisl [J]. Crit Care Med, 1994,22(4) :640.
6Dellinger RP,Carlet JM,Masur H,et al.Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock[J].Crit Care Med,2004,32(3):858-73.
7Levy MM,Fink MP,Marshall JC,et al.2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J].Crit Care Med,2003,31:1250-6.
8Rivers E,Nguyen B,Havstad S,et al.Early goal-directed therapy in the treatment of severe sepsis and septic shock[J].N Engl Med,2001,345(19):1368-77.
