【摘要】 目的探讨危重病患者早期动脉血乳酸清除率、中心静脉血氧饱和度(SCVO2)的监测价值。方法前瞻性观察2012年1～12月106例危重病患者,测定入科即刻、6h动脉血乳酸浓度和早期中心静脉血氧饱和度,计算6h乳酸清除率,并进行急性生理与慢性健康评分(APACHEⅡ)评分,根据APACHEⅡ评分将患者分为4组:<10分组(A组),10～<20分组(B组),20～<30分组(C组),≥30分组(D组),比较不同组别早期乳酸清除率及SCVO2的差别,并分析其与患者预后的关系。结果 B组早期乳酸清除率、SCVO2均低于A组,但差异无统计学意义(P>0.05);C组早期6h乳酸清除率、SCVO2均低于B组,D组亦低于C组(P<0.05);B组病死率高于A组,差异无统计学意义(P>0.05);C组病死率高于B组,D组高于C组(P<0.05)。死亡组APACHEⅡ评分高于存活组,早期动脉血乳酸清除率及SCVO2水平低于存活组(P<0.01)。APACHEⅡ评分与早期乳酸清除率显著负相关(r=0.560,P<0.01),与早期SCVO2水平显著正相关(r=0.642,P<0.01)。结论早期动脉血乳酸清除率及SCVO2水平是反映危重病患者病情严重程度和预测患者转归的良好指标。更多还原

【Abstract】 Objective To explore the value of the early artery lactate clearance rate and the central venous oxygen saturation in critical ill patients.Methods Observed 106 critically ill patients in 2012 January to December.Initial,6 h arterial blood lactate concentration and early central venous oxygen saturation were determined after into the division,calculating 6 h lactate clearance rate,and APACHE Ⅱ score.The patients were divided into four groups according to the APACHE Ⅱ score:<10 point group(group A),10-<20 point group(group B),20-<30 point group(group C),≥30 point group(group D).Compare different groups of early lactate clearance rate and central venous oxygen saturation difference,and analyze their relationship with the prognosis of patients.Results Compared group A,early lactate clearance rate,SCVO2 were lower in group B,but there was no significant difference(P>0.05);Group C early lactate clearance rate,SCVO2 were lower than group B,group D also lower than in group C(P<0.05).Group B mortality rate was higher than in group A,but there was no significant difference(P>0.05);Group C higher than in group B,and group D higher than group C(P<0.05).Death group APACHE Ⅱ score higher than the survival group,and early lactate clearance rate and SCVO2 level lower than the survival group(P<0.01).APACHE Ⅱ score and early lactate clearance was significantly negatively correlated(r=0.560,P<0.01),and early SCVO2 level was significantly positively correlated(r=0.642,P<0.01).Conclusion Early lactate clearance rate and central venous oxygen saturation level is a good indicator to reflect critically ill patients and the severity of the disease,which is a good indicator to predict patient outcome.更多还原