感染性休克患者复苏24h内乳酸清除率对预后的评估价值

发布时间：2018-02-22 10:20

本文关键词： 感染性休克乳酸乳酸清除率预后　出处：《中华医院感染学杂志》2016年19期 　论文类型：期刊论文

【摘要】：目的研究感染性休克患者复苏24h内乳酸清除率对预后的评估价值,以更好的指导液体复苏治疗。方法对2014年6月-2015年6月入住医院ICU治疗34例感染性休克患者进行前瞻性研究,记录复苏开始时及6、24h的乳酸值,并计算乳酸清除率,根据患者28天病死率分为死亡组10例和存活组24例,比较组间复苏6、24h乳酸值及乳酸清除率、APACHEⅡ评分、机械通气时间等指标的差异,通过ROC曲线分析乳酸清除率对预后的评估价值。结果两组患者的初始乳酸值、6h乳酸清除率、机械通气时间等指标差异无统计学意义;复苏6、24h乳酸值及24h乳酸清除率死亡组为(6.79±4.39)(6.13±3.75)mmol/L及(22.10±34.73)%,存活组为(3.27±2.69)(2.33±2.44)mmol/L及(50.74±20.25)%,两组比较差异有统计学意义(P0.05);6、24h乳酸清除率对预后评估的ROC曲线的曲线下面积(AUC)分别为0.65、0.76。结论液体复苏24h内乳酸清除率与预后密切相关,即使在黄金6h以后,如果乳酸清除率不达标,仍应继续复苏治疗。
[Abstract]:Objective to study the value of lactate clearance rate in evaluating the prognosis of patients with septic shock within 24 hours after resuscitation, and to provide better guidance for fluid resuscitation therapy. Methods 34 patients with septic shock treated with ICU from June 2014 to June 2015 were prospectively studied. The lactate values at the beginning of resuscitation and at 6h after resuscitation were recorded, and the lactate clearance rate was calculated. According to the fatality rate of 28 days, 10 patients were divided into death group (n = 10) and survival group (n = 24). The difference of mechanical ventilation time and other indexes was analyzed by ROC curve. Results there was no significant difference in the initial lactate clearance rate and mechanical ventilation time between the two groups. The values of lactate at 6 h after resuscitation and the clearance rate of lactate at 24 h were 6.79 卤4.39 nmol / L and 22.10 卤34.73g / L in the death group, 2.27 卤2.69 mmol / L and 50.74 卤20.25m / L in the survival group, respectively. Conclusion the area under the ROC curve of the 24 h lactate clearance rate in the two groups is 0.650.760.Conclusion the area under the ROC curve is 0.650.760.Conclusion the area under the ROC curve is 0.650.760.Conclusion the difference between the two groups is statistically significant. The clearance rate of lactic acid in 24 hours was closely related to the prognosis. Even after 6 hours after gold, if the lactate clearance rate is not up to the standard, should continue to resuscitation therapy.
【作者单位】：扬州大学第五临床医学院常熟市第二人民医院重症医学科;
【基金】：常熟市卫计委指导性基金资助项目(csws201414)
【分类号】：R459.7

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