高原地区动脉血乳酸清除率对感染性休克患者的预后评估价值分析

The Evaluation on the Rate of Plateau Arterial Blood Lactate Clearance for the Prognosis of Patients with Septic Shock

目的:高原地区动脉血乳酸清除率对感染性休克患者的预后评估价值。方法:采用前瞻性自身对照的临床研究方法,选取青海红十字医院重症医学科60例感染性休克患者,集束化治疗过程中进行动脉血乳酸测定。入ICU时、治疗6小时后、24小时后进行动脉血乳酸测定,计算6h、24h动脉血乳酸清除率,按住院28天转归,将患者分为存活组36例和死亡组24例,观察两组患者APACHEⅡ评分、6h及24h血乳酸水平和乳酸清除率差异,从而评估与感染性休克患者预后的关系。结果:存活组与死亡组相比较,入ICU动脉血乳酸值差异无统计学意义(P>0.05),在APACHEⅡ评分、6h乳酸清除率及24h乳酸清除率方面差异有统计学意义(P<0.05)。结论:高原地区动脉血乳酸清除率可以有效评估感染性休克患者的总体预后。

Objective：This article is aimed to evaluate the predictive value of plateau arterial blood lactate clearance rate for the prognosis of patients with septic shock. Methods： By the method of prospective own controlled clinical research, 60 patients with septic shock,who were chosen in ICU of The Red Cross hos-pital of Qinghai, were tested the arterial blood lactic acid in the process of cluster treatment. In the ICU, the arterial blood lactate was tested after 6 hours and 24 hours＂ treatment, while calculating the blood lac-tate clearance rate. According to hospital 28 days＂ outcome, 36 cases were divided into survival group and 24 cases in death group, observing two groups＂ APACHE lI scores, 6h and 24h blood lactic acid level differences and lactate clearance in order to assess their relationship with the prognosis of patients with septic shock.Results： In contrast, there was no statistically significant difference in ICU arterial blood lactic acid value （P-0.05） between the survival group and death group, but as to the APACHEH scores, the differences between clearance of lactic acid and lactate clearance after 6 hours and 24 hours were statistical- ly significant （P-0.05）.Conclusion：The rate of plateau arterial blood lactate clearance can effectively eval- uate the overall prognosis of patients with septic shock.