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乳酸清除率联合碱剩余对严重脓毒症目标性治疗效果及预后的评估 被引量:9

The Values of Combing Base Excess and Lactate Clearance in Assessment of Goal-directed Therapy and Prognosis of Severe Sepsis
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摘要 目的探讨乳酸清除率联合碱剩余对严重脓毒症目标性治疗效果及预后评估的价值。方法回顾性分析天津医科大学第二医院ICU2006年1月至2009年1月临床资料完整的60例严重脓毒症患者,根据28 d转归分为生存组38例,死亡组22例,比较目标性治疗6 h后生存组与死亡组患者乳酸、碱剩余、乳酸清除率、6 h和48 h急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,将目标性治疗6 h后碱剩余及乳酸清除率与48 h APACHEⅡ评分进行相关分析。结果经目标性治疗6 h后生存组患者乳酸清除率明显高于死亡组(P<0.05),碱剩余亦明显高于死亡组(P<0.05),而血乳酸和入院6 h APACHEⅡ评分生存组与死亡组无统计学意义(P>0.05),6 h的碱剩余及乳酸清除率与48 h APACHEⅡ评分均具有相关性(P<0.05)。结论乳酸清除率联合碱剩余可以评估严重脓毒症目标性治疗的疗效和判断预后。 Objective To investigate the values of combing base excess and lactate clearance in assessment of goal-directed therapy and prognosis of severe sepsis.Methods According to the outcome 28 days after admission,retrospectively analyze the 60 patients with severe sepsis and whole date,which were divided into survival group(n=38)and death group(n=22),the lactate,buffuer excess,lactate clearance,6 and 48 hoursacute physiology and chronic health evaluation Ⅱ(APACH Ⅱ)score between 2 groups are compared,the relations of the base excess and lactate clearance to APACH Ⅱ score in 48 hours were analyzed.Results Base excess and 6 hours lactate clearance after admission between 2 groups has statistical signification(P〈0.05).There are relativity between the base excess,lactate clearance and APACH Ⅱ score in 48 hours(P〈0.05).Conclusion Combing base excess and lactate clearance can evaluate the effect of directed therapy and the prognosis of severe sepsis.
作者 赵华杰 刘毅
出处 《医学综述》 2010年第10期1580-1582,共3页 Medical Recapitulate
关键词 碱剩余 乳酸清除率 脓毒症 预后 Base excess Lactate clearance Sepsis Prognosis
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参考文献8

  • 1Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.The ACCP/SCCM Consensus Conference Committee.American College of Chest Physicians/Society of Critical Care Medicine[J].Chest,1992,101 (6):1644-1655.
  • 2Levy MM,Fink MP,Marshall JC,et al.2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J].Crit Care Med2003,31(4):1250-1256.
  • 3Nguyen HB,Rivers EP,Knoblich BP,et al.Early lactate clearance is associated with improved outcome in severe sepsis and septic shock[J].Crit Care Med,2004,32(8):1637-1642.
  • 4吴立峰,李子龙,方强.早期乳酸清除率对严重脓毒症、脓毒性休克病人的预后评估作用[J].现代实用医学,2007,19(5):345-347. 被引量:9
  • 5沈晔,吴双华,潘景业,程留慧,张近波,马继红.碱剩余早期动态变化和乳酸清除率对脓毒症患者预后的评估[J].中国急救复苏与灾害医学杂志,2008,3(11):668-670. 被引量:21
  • 6Nguyen HB,Rivers EP,Havstad S.Critical care in etnergpncy department:a physiolog,assment and outcome evaluation[J].Acad Eimrg Med,2000,7(7):1354-1361.
  • 7Spahn DR,Cemy V,Coats TJ,et al.Management of bleeding following major trauma:a European guideline[J].Crit Care,2007,11(1).414-436.
  • 8Raghavan M,Marik PE.Management of sepsis during the early "widen hours"[J].J Emere Med.2006.31(2):185-199.

二级参考文献16

  • 1[1]Nguyen HB,Rivers EP,Knoblich BP,et al.Early lactate clearance is associated with improved outcome in severe sepsis and septic shock.Crit Care Med,2004,32(8):1637-1642.
  • 2[2]Spahn DR,Corny V,Coats TJ,et al.Management of bleeding following major trauma:a European guideline.Crit Care,2007,11(1):414-436.
  • 3[3]Park M,Azevedo LCP,Maciel AT,et al.Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy:still outcome markers?Clinics,2006,61(1):47-52.
  • 4[4]Palma LC,Ferreira GF,Amaral ACKB,et al.Acidosis and mortality in severe sepsis and septic shock evaluated by base excess variation.Crit Care,2003,7:39.
  • 5[5]Raghavan M,Marik PE.Management of sepsis during the early"golden hours".J Emerg Med.2006,31(2):185-199.
  • 6Dellinger P,Carlet JM,Masur H,et al.Surviving sepsis campaign gudelines management of severe sepsis and septic shock[J].Intensive Car Med,2004,30(6):536-555.
  • 7Nguyen HB,Emanuel P,Rivers,et al.Early lactate clearance is associated with improved outcome in severe sepsis and septic shock[J].Crit Care Med,2004,32(8):1637-1642.
  • 8Levy MM,Fink MP,Marshall JC,et al.SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference[J].Crit Care Med,2003,31 (4):1250-1256.
  • 9Revers E,Nguyen B,Havstad S,et al.Early goal-directed therapy in the treatment of severe sepsis and septic shock[J].N Engl J Med,2001,345(9):1368-1377.
  • 10Hayes MA,Timmins AC,Yau EH,et al.Oxygen transport patterns in patients with sepsis syndrome or septic shock:Influence of treatment and relationship to outcome[J].Crit Care Med,1997,25 (4):926-936.

共引文献28

同被引文献81

  • 1王丽霞,李凤云.脓毒血症1例分析[J].中国误诊学杂志,2009,9(3). 被引量:6
  • 2宁波.阴离子间隙的临床应用[J].空军医学杂志,2011,27(3):123-124. 被引量:3
  • 3Wen-Hui Wu,Yuan-Yuan Niu,Chang-Ran Zhang,Long-Bin Xiao,Hui-Shao Ye,De-Mao Pan,Mian Zeng.Combined APACH Ⅱ score and arterial blood lactate clearance rate to predict the prognosis of ARDS patients[J].Asian Pacific Journal of Tropical Medicine,2012,5(8):656-660. 被引量:21
  • 4慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华内科杂志,2007,46(3):254-261. 被引量:1797
  • 5中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007修订版).中华结核和呼吸杂志,2007,30:817-817.
  • 6Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Cam- paign : international guidelines for management of severe sepsis andseptic shock[J]. Grit Care Med, 2008, 36(1 ) : 296 -327.
  • 7Carlbom D J, Rubenfeld GD. Barriers to implementing protocol - based sepsis resuscitation in the emergency department - results of a national survey[J]. Grit Care Med, 2007, 35 ( 11 ) : 2525 - 2532.
  • 8Jones AE, Shapiro NI, Roshon M. Implementing early goal direct- ed therapy in the emergency setting: the challenges and experi- ences of translating research innovations into clinical reality in aca- demic and community settings [ J ]. Acad Emerg Med, 2007, 14 (11): 1072 -1078.
  • 9Jones AE. Clearance be substituted for central venous oxygen satu- ration as goals of early severe sepsis and septic shock therapy? Yes [J]. Chest, 2011, 140(6) : 1406 -1408.
  • 10Jones AE, Shapiro NI, Trzeeiak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy a randomized clinical trial[ J]. JAMA, 2010, 303 (8): 739- 746.

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