血乳酸清除率在严重脓毒症早期液体复苏的应用价值

Application value of lactate clearance rate in early fluid resuscitation of patients with severe sepsis

目的探讨血乳酸清除率在严重脓毒症早期液体复苏中的应用价值。方法选择笔者所在医院ICU收治的34例严重脓毒症患者,随机分为观察组(早期达标治疗联合血乳酸清除率组)和对照组(早期达标对照组),观察组参照2006年成人严重感染与感染性休克指南早期达标治疗目标并监测乳酸清除率给予积极液体复苏,对照组除未测定乳酸外,其余治疗同观察组。比较两组治疗前、治疗后6 h的治疗效果。结果观察组显著地增加每小时尿量、降低APACHE-Ⅱ评分,减少住院时间,降低费用,与对照组相比较差异有统计学意义(P<0.05)。结论血乳酸清除率指导严重脓毒症早期液体复苏能改善病情且能降低住院费用。

Objective To study the application value of lactate clearance rate in early fluid resuscitation of the patients with severe sepsis. Methods This study selected the 34 patients with severe sepsis who admitted in ICU of author＇s hospital. Among them 17 cases as observation group treated with early goal directed therapy （EDGT）combined with detection of lactate clearance rate were compared with other 17 cases as control group treated with EDGT. The effect before and after （at 6 hour） treatment were observed. Results Better effect were presented in the observation group,and statistically significant differences were showed between the two groups（P〈0.05）. Conclusion Lactate clearance rate can effectively direct therapy of early fluid resuscitation in patients with severe sepsis,and reduce medical cost.