血乳酸监测对颅脑外伤患者病情评估及预后的临床研究

Clinical research of blood lactate monitoring to assess the condition and prognosis of patients with brain injury

目的探讨血乳酸动态监测在重型颅脑外伤中病情评估及与患者预后的临床意义。方法将52例重型颅脑外伤患者,根据入院时格拉斯哥昏迷评分(GCS)评分分为2组,分别对2组患者入院0、12、24、48、72 h及第7天的血乳酸进行检测,并分别计算每个乳酸监测点的乳酸清除率,且与2组患者的死亡率进行比较。结果 52例重型颅脑外伤患者入院早期均有不同程度血乳酸增高,治疗后各个时点的乳酸清除率除第7天外均有明显降低,差异均有统计学意义(P<0.05)。结论重型颅脑外伤患者早期血乳酸均有不同程度增高,血乳酸增高越明显,持续时间越长,损伤程度越重,预后越差;血乳酸动态监测可作为评估颅脑外伤患者预后的一个重要指标。

Objective To study the dynamic monitoring of blood lactic acid in severe craniocerebral injury condition.Methods 52 patients with severe craniocerebral injury are collected. According to the Glasgow Coma scale（ G1 asgow Coma Seale,GCS） score,patients admitted to hospital were randomly divided into two groups. Blood lactic acid were measured at 0 hours（ h）,12 h,24 h,48 h,72 h and 7 days,and the clearance were calculated,and two groups of patients’ mortality were compared. Results The blood lactic acid of 52 cases of heavy craniocerebral trauma patients admitted to hospital early all increased at different levels,and each point of the lactate clearance rate decreased after treatment at any time except for 7,which were statistically significant（ P 〈 0. 05）.Conclusion Early blood lactic acid could increase to some extent in patients with severe craniocerebral injury. Blood lactic acid could increase the more and the longer of duration,the more of damage and the worse prognosis. Blood lactate dynamic monitoring can be used as an important criterion for evaluation of the prognosis of patients with craniocerebral injury.