动脉血乳酸和乳酸清除率在感染性休克治疗中的价值探讨

Value of Arterial Blood Lactic Acid and Lactate Clearance Rates in the Treatment of Septic Shock

目的探讨动脉血乳酸和乳酸清除率在感染性休克治疗中的应用价值。方法 92例感染性休克患者治疗前予动脉血乳酸测定及急性生理和慢性健康状况评分(APACHEⅡ),早期目标导向治疗(EGDT)后根据疗效分为达标和未达标组,并根据28d病程转归分为存活和死亡组,分别比较各组间血乳酸、乳酸清除率和APACHEⅡ的差异。结果 达标组6h血乳酸和乳酸清除率与未达标组比较均有统计学意义(P<0.05),APACHEⅡ无统计学差异(P>0.05),存活组24h血乳酸、乳酸清除率和APACHEⅡ与死亡组比较均有统计学差异(P<0.05)。结论动态血乳酸变化和乳酸清除率可作为感染性休克评价疗效和预后的指标。

Objective To explore the value of arterial blood lactic acid and lactate clearance Methods Ninty-two patients with septic shock before treatment for arterial blood lactic acid rates in the treatment of septic shock. t and acute physiology and chronic health evaluation （APACHEⅡ）, afterearly goal-directed therapy （EGDT）,divided into the sufficiently resuscitated and insufficiently resuscitated groups basis on therapeutic effect, and disease outcome according to 28d divided into survival and dead group were compared among the groups of blood lactic acid, lactate clearance rate and APACHE Ⅱ differences. Results There were significantly difference in the 6h arterial blood lactic acid and lactate clearance ratesbetween the sufficiently resuscitated and the insufficiently resuscitated group （P〈0.05）, APACHE Ⅱ was no significant difference （P〉0.05） the survival group 24h blood lactic acid, lactate .clearance rates and APACHE Ⅱ was even with the dead group has statistics difference （P〈0.05）. Conclusion Dynamic changes in blood lactic acid and lactate clearance rates as septic shock evaluate the efficacy and prognosis.