研究动态监测动脉血乳酸浓度联合早期血乳酸清除率对感染性休克患者预后的评估

Study of Dynamic Monitoring of Arterial Blood Lactate Concentration Combined with Early Blood Lactate Clearance to Assess Prognosis in Patients with Septic Shock

目的分析动态监测动脉血乳酸浓度联合早期血乳酸清除率对感染性休克患者预后的评估价值。方法选取武威市人民医院急救中心2016年1月至2019年1月接诊的80例感染性休克患者作为观察对象,随机分为对照组和观察组,每组40例。对照组患者采用常规治疗,观察组患者在常规治疗的基础上,采用动态监测动脉血乳酸浓度,并实施早期血乳酸清除。对比2组患者死亡率和治疗总有效率。结果观察组患者死亡率为2.50%(1/40),显著低于对照组的15.00%(6/40),组间比较差异有统计学意义(P<0.05);观察组的治疗总有效率为97.50%(39/40),高于对照组的75.00%(30/40),组间比较差异有统计学意义(P<0.05);观察组患者入院后6 h动脉血乳酸水平为(2.33±1.16)mmol/L,入院12 h的动脉血乳酸水平为(1.92±0.22)mmol/L,入院后24 h动脉血乳酸水平为(1.52±0.46)mmol/L,入院后48 h动脉血乳酸水平水平为(1.41±0.26)mmol/L,均低于对照组的(4.01±1.04)mmol/L、(3.78±0.36)mmol/L、(2.83±0.35)mmol/L、(2.44±0.24)mmol/L,组间比较差异有统计学意义(P<0.05)。结论动态监测动脉血乳酸浓度联合早期血乳酸清除率能够为感染性休克患者的治疗提供参考,预示病情严重程度及患者预后,降低患者死亡率,提高治疗效果,值得临床推广应用。

Objective To analyze the prognostic value of dynamic monitoring of arterial blood lactate concentration combined with early blood lactate clearance in patients with septic shock.Methods A total of 80 patients with septic shock who were admitted to the Emergency Center of Wuwei People's Hospital from January 2016 to January 2019 as an object of observation.The patients were randomLy divided into control group and observation group with 40 cases in each group.Patients in the control group received routine treatment,and patients in the observation group received dynamic monitoring of arterial blood lactate concentration and early blood lactate clearance on the basis of routine treatment.The mortality rate and total response rate were compared between the two groups.Results The mortality rate in the observation group was 2.50%(1/40),which was significantly lower than that in the control group 15.00%(6/40),and the difference was statistically significant(P<0.05).The total effective rate of the observation group was 97.50%(39/40)higher than that of the control group 75.00%(30/40),the difference was statistically significant(P<0.05).In the observation group,the arterial blood lactate level was(2.33±1.16)mmol/L at 6 h after admission,(1.92±0.22)mmol/L at 12 h after admission,and(1.52±0.46)mmol/L at 24 h after admission,and 48 h after admission.H Arterial blood lactate level was(1.41±0.26)mmol/L,which was lower than(4.01±1.04)mmol/L,(3.78±0.36)mmol/L,(2.83±0.35)mmol/L and(2.44±0.24)mmol/L in the control group,and the difference was statistically significant(P<0.05).Conclusion Dynamic monitoring of arterial blood lactate concentration combined with early blood lactate clearance can provide a reference for the treatment of patients with septic shock,predict the severity of the disease and the prognosis of the patient,reduce the mortality of the patient,improve the treatment effect,and is worth using.