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目的评估早期乳酸清除率与外科手术后严重脓毒症病人预后的关系。方法前瞻性观察并收集中山大学附属第一医院外科2004年7月至2007年6月因术后严重脓毒症进入外科重症监护病房206例病人的APACHEⅡ评分、入ICU6h动脉血乳酸清除率及病人预后的相关资料。将病人分成存活组和死亡组,高乳酸清除率组和低乳酸清除率组,比较其差异性。结果各组年龄、性别、APACHEⅡ评分和基础血乳酸值差异无显著性意义(P>0.05)。存活组乳酸清除率明显高于死亡组[(28.8±11.7)%对(15.2±11.2)%,P<0.01];高乳酸清除率组病死率均明显低于低乳酸清除率组(26.7%对51.1%,P<0.001)。结论早期乳酸清除率可用于评估外科术后严重脓毒症的预后。
Objective To assess the relationship between early lactic acid clearance and the prognosis of patients with severe sepsis after surgery. Methods The APACHE II score of 206 patients admitted to the surgical intensive care unit from July 2004 to June 2007 in the Department of Surgery, The First Affiliated Hospital of Sun Yat-sen University from July 2004 to June 2007 was prospectively collected and collected. The arterial lactate clearance rate and patient Prognosis related information. The patients were divided into survival and death groups, high lactic acid clearance group and low lactic acid clearance group, the difference was compared. Results There was no significant difference in age, gender, APACHEⅡscore and basal blood lactate value among all groups (P> 0.05). The survival rate of lactic acid in survival group was significantly higher than that in death group [(28.8 ± 11.7)% vs (15.2 ± 11.2)%, P <0.01]. The mortality in high lactic acid clearance group was significantly lower than that in low lactic acid clearance group (26.7% 51.1%, P <0.001). Conclusions Early lactate clearance can be used to assess the prognosis of severe post-surgical sepsis.