早期乳酸清除率对重型颅脑损伤患者预后评估的临床分析

The clinical analysis of evaluating early lactate clearance rate to the prognosis of patients with severecraniocerebral injury

目的回顾性研究早期乳酸清除率与重型颅脑损伤患者预后的相关性。方法收集267例重型颅脑损伤患者入ICU后的APACHEⅡ评分、MOFS发生率、入ICU 12h后乳酸清除率及患者转归。分别将病例分成存活组和死亡组,高乳酸清除率组和低乳酸清除率组,比较其差异的统计学意义。结果各组年龄、性别、APACHEⅡ评分比较差异均无统计学意义(P>0.05)。存活组MOFS发生率明显低于死亡组(33.57%vs 66.29%,P<0.01),乳酸清除率明显高于死亡组[(32.56±15.69)%vs(13.67±14.56)%,P<0.01];高乳酸清除率组MOFS发生率、病死率均明显低于低乳酸清除率组(33.09%vs 64.10%,28.16%vs 76.92%,P均<0.01)。结论乳酸清除率可用于早期评估重型颅脑损伤患者的预后转归。

Objective To retrospective study on the correlation between early lactate clearance rate and prognosis in patients with severe craniocerebral injury.Methods APACHE II score of 267 ICU critical ill patients with severe craniocerebral injury,morbidity of MOFS,the 12-hour lactate clearance rate after entering ICU and the patients outcome were collected.The patients were respectively devidded into survival group and death group,high lactate clearance rate group and low clearance rate group,to compare the statistical significance.Results There were no significant difference in age、gender、APACHE II score.In survival group,the morbidity of MOFS was significantly lower than that in death group,and the lactate clearance rate was higher than in death group.Mobidity of MOFS and mortality in high lactate clearance rate group were significantly lower than in the low lactate clearance rate group.Conclusion Lactate clearance rate can be used to assess the evelution and progrosis of patients with severe craniocerebral injury.