血乳酸水平动态监测在危重症患者的应用的临床价值分析

The Clinical Value Analysis of Dynamic Monitoring of Blood Lactate Levels in Critically Ill Patients

目的：探讨动态监测动脉乳酸水平对危重患者的应用的临床价值分析。方法：对2010年2月~2011年6月间收治的危重病患者的血乳酸水平进行动态监测,通过比较死亡组患者和存活组患者乳酸水平及其它临床指标,比较不同乳酸水平组患者的临床资料来分析乳酸在危重症患者的应用价值。结果：死亡组和存活组患者在性别、年龄差异无明显的统计学意义（P〉0.05）;病死组乳酸水平、APACHEⅡ评分、住ICU时间（天）、机械通气时间明显高于生存组,差异有显著的统计学意义（P〈0.01）;严重乳酸酸中毒组患者在APACHEⅡ评分、休克发生率、MODS发生率、死亡发生率均明显高于乳酸酸中毒组和高乳酸血症组,差异有明显的统计学意义（P〈0.05）,乳酸酸中毒组休克发生率、MODS发生率、死亡发生率均明显高于高乳酸血症组,差异有明显的统计学意义（P〈0.05）。结论：动态监测动脉乳酸水平是判断危重患者预后的一个良好指标,动脉乳酸越高,预后差。

Objective： To investigate the clinical value analysis of dynamic monitoring of blood lactate levels in critically ill patients.Methods： Blood lactate levels of critically ill patients admitted from February 2010 to June 2011 were dynamic monitored.The level of lactic acid and other clinical indicators of death and survival patients were compared.The clinical value of lactic acid levels of critically ill patients were analyzed by comparing clinical datas of different lactate levels groups.Results： The difference of gender,age in the death group and survival group was not statistically significant（P〈0.05）.The lactate levels,APACHE Ⅱ score,ICU stay（days）,mechanical ventilation time of the death group was significantly higher than the survival group,the difference having statistical significance（P〈0.01）.The APACHE Ⅱ score,incidence of shock,MODS incidence,mortality in the severe lactic acidosis group were significantly higher than those of the lactic acidosis group,the difference was statistically significant（P〈0.05）.The shock and MODS incidence,mortality in the lactic acidosis group were significantly higher than the hight lactic level group,the difference was statistically significant（P〈0.05）.Conclusion： Dynamic monitoring of arterial lactate levels in critically ill patients is a good indicator of prognosis,the higher arterial lactate,and poor prognosis.