早期乳酸清除率评估与失血性低血容量休克预后的研究

目的评估失血性低血容量休克患者早期乳酸清除率与预后的关系。方法前瞻性观察并收集因失血性低血容量休克进入外科重症监护病房92例患者的APACHEII评分、入ICU6h后动脉血乳酸清除率及患者预后。分别将患者分成存活组和死亡组,高乳酸清除率组(6h乳酸清除率10%)和低乳酸清除率组(6h乳酸清除率10%),比较各组间的差异。结果各组年龄、性别、APACHEII评分和基础血乳酸值差异无统计学意义。存活组乳酸清除率明显高于死亡组[(29.8±15.2)%vs(9.8±9.1)%,0.01];高乳酸清除率组病死率均明显低于低乳酸清除率组(11.3%vsP42.9%,P0.01)。结论早期乳酸清除率10%能准确评估失血性低血容量休克患者的良性预后。

Clinical significance of early lactate clearance on prognosis in patients with hemorrhagic hypo volemic shock

Objective To evaluate the correlation between the prognosis and the earlylactate clearance in patients with hemorrhagic hypovolemic shock.Methods Prospective observation and collecting the data of 92 patients with hemorrhagic hypovolemic shock.APACHE II score,the mortality and the lactate clearance after 6hours were measured.The patients were analyzed with respect to survival and nonsurvival,low lactate clearance and high lactate clearance.Results There was no statistical difference between the two groups in age,sex,A-PACHE II score and the baseline of lactate.The early lactate clearance in survival group was significantly more than that in the nonsurvival group,（29.8±15.2）% vs（9.8±9.1）%,0.01.The mortalitywas in high lactate clear-Pance group significantly less than that in the low lactate group,11.3% vs 42.9%,P0.01.Conclusion The early lactate clearance is a good prognostic factor of hemorrhagic hypovolemic shock.