危重症患者氧利用率及动脉血乳酸水平变化与预后的关系

Relationship between variational oxygen utilization coefficient,arterial lactic acid and prognosis in critically ill patients

目的探讨危重患者氧利用率(O2UC)及动脉血乳酸水平变化与预后的关系。方法选取2011年9月—2012年12月本院重症监护室(ICU)收治的危重症患者75例,分别统计入住ICU时及入住后第1、2、3、5、7天生存者(生存组)及死亡者(死亡组)。比较2组O2UC、动脉血乳酸水平动态监测结果,最终生存者及死亡者急性生理和慢性健康状况评分系统Ⅱ(A-PACHEⅡ)及多器官功能障碍综合征(MODS)的发生率;探讨O2UC与动脉血乳酸水平之间的关系。结果入住ICU后第2、3、5、7天生存组O2UC均显著高于死亡组;入住ICU后第1、2、3、5、7天生存组动脉血乳酸水平均显著低于死亡组。最终死亡者APACHEⅡ评分、MODS发生率均显著高于生存者。O2UC与动脉血乳酸水平无相关性。结论 O2UC及动脉血乳酸水平是判断危重患者预后的良好指标。O2UC越低,动脉血乳酸水平越高,预后越差。

Objective To investigate the relationship between variational oxygen utilization coefficient（O2UC）,arterial lactic acid and prognosis in critically ill patients.Methods Seventy-five critically ill patients from September,2011 to December,2012 in ICU were selected.The survival（survival group） and dead patients（dead group） at the time of being admitted to ICU and on 1,2,3,5,7 d after hospitalization were summed.The dynamic monitoring results of O2UC and arterial lactic acid level of two groups,the incidences of acute physiology and chronic health evaluation system Ⅱ（APACHE Ⅱ） and multiple organ dysfunction syndrome（MODS） of final survival and dead patients were compared.The relationship between O2UC and arterial lactic acid was explored.Results The O2UC on 2,3,5,7 d after being admitted to ICU in survival group was obviously higher than that in dead group.The arterial lactic acid levels on 1,2,3,5,7 d after being admitted to ICU in survival group were obviously lower than those in dead group.The APACHE Ⅱ score and MODS incidence of final death patients were obviously higher than those in survival patients.O2UC had no correlation with arterial lactic acid level.Conclusion O2UC and arterial lactate level are good indexes for judging the prognosis of critically ill patients.The lower O2UC is,the higher arterial lactic acid level is,and the worse prognosis is.