[1]张 雪.乳酸清除率评估严重脓毒症及脓毒性休克预后的价值[J].医学信息,2020,33(16):104-106.[doi:10.3969/j.issn.1006-1959.2020.16.031]
　ZHANG Xue.The Value of Lactate Clearance Rate in Evaluating the Prognosis of Severe Sepsis and Septic Shock[J].Medical Information,2020,33(16):104-106.[doi:10.3969/j.issn.1006-1959.2020.16.031]
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乳酸清除率评估严重脓毒症及脓毒性休克预后的价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年16期
页码:
104-106
栏目:
临床研究
出版日期:
2020-08-15

文章信息/Info

Title:
The Value of Lactate Clearance Rate in Evaluating the Prognosis of Severe Sepsis and Septic Shock
文章编号:
1006-1959（2020）16-0104-03
作者:
张 雪
（天津市津南医院ICU，天津 300350）
Author(s):
ZHANG Xue
(ICU,Tianjin Jinnan Hospital,Tianjin 300350,China)
关键词:
乳酸清除率; 严重脓毒症; 脓毒性休克
Keywords:
Lactic acid clearance rate; Severe sepsis; Septic shock
分类号:
R631
DOI:
10.3969/j.issn.1006-1959.2020.16.031
文献标志码:
A
摘要:
目的 探讨乳酸清除率评估严重脓毒症及脓毒性休克治疗效果。方法 选取2019年4月~2020年2月我院收治的严重脓毒症及脓毒性休克患者共68例，根据预后情况分为死亡组（24例）与存活组（44例），比较两组治疗前ABL水平、乳酸清除率，分析乳酸清除率与72h APACHEⅡ评分的一致性、各时间点的乳酸值、乳酸清除率与预后的关系。结果 两组治疗前ABL水平比较，差异无统计学意义（P＞0.05）；两组治疗后ABL水平较治疗前降低，且死亡组高于存活组，差异有统计学意义（P＜0.05）；存活组3、6 h乳酸清除率高于死亡组，差异有统计学意义（P＜0.05）；存活组APACHEⅡ评分为（17.02±4.56）分，低于死亡组的（21.74±5.37）分，差异有统计学意义（P＜0.05）。相关性分析显示，乳酸清除率与APACHEⅡ评分呈负相关（r=-0.480，P＜0.05）。复苏后6 h血乳酸值对死亡组预后评估有较高的预测价值，其灵敏度、特异度分别为90.80%、100.00%；复苏后6 h乳酸清除率同样对脓毒症患者预后评估有较高的预测价值，其灵敏度、特异度分别为100.00%、81.90%。结论 通过检测乳酸清除率可以对严重脓毒症、脓毒性休克患者治疗效果、预后进行有效地判断，且治疗后的6 h评估预后、疗效是最佳的时间。
Abstract:
Objective To explore the lactic acid clearance rate to evaluate the treatment effect of severe sepsis and septic shock.Methods A total of 68 patients with severe sepsis and septic shock admitted to our hospital from April 2019 to February 2020 were selected. According to the prognosis, they were divided into a death group (24 cases) and a survival group (44 cases), and the two groups were compared. ABL level and lactate clearance rate before treatment, the consistency of lactate clearance rate and 72h APACHEⅡ score, the relationship between lactate value at each time point, lactate clearance rate and prognosis were analyzed.Results There was no statistically significant difference in ABL levels between the two groups before treatment (P>0.05); ABL levels after treatment in the two groups were lower than before treatment, and the death group was higher than the survival group, the difference was statistically significant (P<0.05); The clearance rate of lactate in the 3 and 6 h group was higher than that of the death group, the difference was statistically significant (P＜0.05); the APACHEⅡ score of the survival group was (17.02±4.56) points, which was lower than the death group (21.74±5.37) points, the difference was statistically significant (P<0.05). Correlation analysis showed that lactate clearance rate was negatively correlated with APACHEⅡ score (r=-0.480,P＜0.05). The blood lactate value at 6 h after resuscitation has a high predictive value for the prognosis evaluation of the death group, and its sensitivity and specificity are 90.80% and 100.00% respectively; the lactate clearance rate at 6 h after resuscitation also has a higher prognostic evaluation for patients with sepsis the predictive value of the sensitivity and specificity are 100.00% and 81.90% respectively.Conclusion The detection of lactic acid clearance rate can effectively judge the treatment effect and prognosis of patients with severe sepsis and septic shock, and it is the best time to evaluate the prognosis and curative effect 6 h after treatment.

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更新日期/Last Update: 1900-01-01