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目的:探究血乳酸水平在重症感染患者预后评价中的参考价值,分析其与患者预后的关系。方法:选取高州市人民医院2015年10月至2016年10月收治的80例重症感染患者,根据患者预后情况分成死亡组(31例)和存活组(49例),并依照乳酸清除率10%分为高乳酸清除率组(清除率>10%,58例)和低乳酸清除率组(清除率<10%,22例),对死亡组和存活组急性生理与慢性健康Ⅱ(APACHEⅡ)评分、乳酸清除率进行比较,并对高乳酸清除率组和低乳酸清除率组生存率、APACHEⅡ评分和血乳酸浓度进行比较。结果:死亡组和存活组患者APACHEⅡ评分、初始血乳酸浓度比较,差异无统计学意义(P>0.05);死亡组患者乳酸清除率显著低于存活组,差异具有统计学意义(P<0.05)。高乳酸清除率组患者生存率显著高于低乳酸清除率组,6 h血乳酸水平显著低于低乳酸清除率组,差异具有统计学意义(P<0.05);两组APACHEⅡ评分比较,差异无统计学意义(P>0.05)。结论:血乳酸水平在重症感染患者预后评价中效果显著,随着患者体内乳酸水平的下降或乳酸清除率的升高,患者死亡率下降,对于患者预后转归及提升生存率具有重要的作用。
Objective: To explore the reference value of blood lactate level in the prognosis evaluation of patients with severe infection and to analyze its relationship with the prognosis of patients. Methods: Eighty patients with severe infection admitted to Gaozhou People’s Hospital from October 2015 to October 2016 were divided into death group (31 cases) and survival group (49 cases) according to their prognosis. According to the rate of lactic acid clearance of 10% The patients were divided into high lactic acid clearance group (clearance rate> 10%, 58 cases) and low lactic acid clearance rate (clearance rate <10%, 22 cases). The APACHE II score of death group and survival group , Lactic acid clearance were compared, and high lactic acid clearance group and low lactic acid clearance group survival rate, APACHE Ⅱ score and blood lactate concentration were compared. Results: There was no significant difference in APACHE Ⅱ score and initial blood lactate concentration between death group and survival group (P> 0.05). The lactic acid clearance rate in death group was significantly lower than that in survival group (P <0.05) . The survival rate of patients with high lactic acid clearance was significantly higher than that of patients with low lactic acid clearance, and the levels of blood lactic acid at 6 hours were significantly lower than those with low lactic acid clearance (P <0.05). There was no significant difference in APACHEⅡscore between the two groups Statistical significance (P> 0.05). Conclusion: The blood lactate level has a significant effect in the prognosis evaluation of patients with severe infection. With the decrease of lactate level or the increase of lactic acid clearance in patients, the mortality of patients is decreased, which plays an important role in prognosis prognosis and survival rate.