论文部分内容阅读
目的:观察急性肠梗阻患者血乳酸及D-二聚体含量与病情转归的关系。方法:以急性肠梗阻患者69例为观察组,以62例非肠梗阻腹痛患者为对照组,比较两组就诊时(T1)、留观12h(T2)及24h(T3)的血乳酸及D-二聚体含量;比较高位肠梗阻组(n=36)及低位肠梗阻组(n=33)患者在首次排便时间(DT)、腹痛持续时间(ST)、梗阻解除时间(OT)及肛门恢复排气时间(VT)的差异;分析乳酸及D-二聚体与上述四个时间指标的关系。结果:肠梗阻患者在T1-T3的乳酸水平呈进行性升高,任意两个时间点的差异均具有统计学意义(P<0.05);肠梗阻患者T2时二聚体显著高于T1,但T3时降低,且与T1及T2无统计学差异。除T1时D-二聚体无组间差异(P>0.05),两组其余时间点的乳酸及D-二聚体均有显著性差异(P<0.05)。低位肠梗阻患者乳酸及D-二聚体含量均高位肠梗阻患者,且低位肠梗阻患者DT、ST、OT及VT均显著长于高位肠梗阻(P均<0.05)。除D-二聚体含量与OT(P>0.05)及VT(P>0.05)无呈显著相关性以外,血乳酸及D-二聚体的含量均与DT、ST、OT及VT均呈显著正相关性(r均>0.06,P均<0.05)。结论:相比D-二聚体,乳酸对肠梗阻的特异性更高,且与肠梗阻的病情转归更为相关,有望作为肠梗阻病情评估的实验室指标之一。
Objective: To observe the relationship between serum lactic acid and D-dimer and the prognosis of patients with acute intestinal obstruction. Methods: A total of 69 patients with acute intestinal obstruction were selected as observation group and 62 patients with non-intestinal obstruction as control group. Blood lactic acid and D at the time of treatment (T1), observation of 12h (T2) and 24h (DT), duration of abdominal pain (ST), obstruction removal time (OT) and anus in the patients with high intestinal obstruction group (n = 36) and low intestinal obstruction group (n = Recovery exhaust time (VT) differences; analysis of lactic acid and D-dimer and the above four time index relationship. Results: The lactic acid levels of patients with ileus were increased progressively at T1-T3, and the difference was statistically significant at any two time points (P <0.05). The dimer at T2 was significantly higher than that of patients with ileus T3 decreased, and with no significant difference between T1 and T2. There was no significant difference (P> 0.05) between the two groups except lactic acid and D-dimer at T1 (P> 0.05). Low intestinal obstruction in patients with lactate and D-dimer were high intestinal obstruction patients, and low intestinal obstruction in patients with DT, ST, OT and VT were significantly longer than the high intestinal obstruction (P all <0.05). The levels of D-dimer and D-dimer were significantly different from those of DT, ST, OT, and VT except that D-dimer had no significant correlation with OT (P> 0.05) and VT Positive correlation (r> 0.06, P <0.05). CONCLUSIONS: Lactic acid is more specific for intestinal obstruction than D-dimer and more relevant to the prognosis of intestinal obstruction and is expected to serve as one of the laboratory markers for assessment of bowel obstruction.