【摘要】 目的探讨血乳酸与APACHEⅡ评分在感染性休克患者中的应用及对预后的影响。方法选择2016年3月—2017年12月入院治疗的感染性休克患者225例,所有患者入院后均采用GEM premier 3000血气分析仪测定患者血乳酸水平,根据血乳酸水平将患者分为A组与B组。采用急性生理学及慢性健康状态评分(APACHEⅡ评分)系统对两组进行评分;根据患者预后分为生存组与死亡组;再次完成生存组与死亡组患者血乳酸与APACHEⅡ评分,采用SPSS Pearson相关性分析软件对感染性休克患者预后与血乳酸、APACHEⅡ评分进行相关性分析。结果 A组189例患者动脉血乳酸≤3.0 mmol/L,B组36例动脉血乳酸>3.0 mmol/L,A组患者APACHEⅡ评分,明显低于B组患者,差异有统计学意义(P<0.05);225例感染性休克患者经我院积极有效的治疗后204例生存,21例患者由于多器官衰竭最终死亡。生存组患者动脉血乳酸水平及APACHEⅡ评分,均明显低于死亡组患者,差异有统计学意义(P<0.05);SPSS Pearson相关性分析结果表明:感染性休克患者预后与血乳酸、APACHEⅡ评分呈正相关性(P<0.05)。结论血乳酸与APACHEⅡ评分用于感染性休克患者中效果理想,能评估患者预后,指导临床治疗,值得推广应用。更多还原

【Abstract】 Objective To investigate the application of blood lactic acid and APACHE Ⅱ scores in patients with septic shock and its influence on prognosis.Methods A total of 225 patients with septic shock who were admitted to hospital from March 2016 to December 2017 were selected. All patients were followed by GEM premier 3000 blood gas analyzer to determine blood lactate levels. Patients were divided into group A and group B according to blood lactate levels. Acute physiology and chronic health status scores( APACHE Ⅱ score) system were used to score the two groups; patients were divided into survival group and death group according to their prognosis; blood lactate and APACHE Ⅱ scores of survival group and death group were completed again,and SPSS Pearson correlation analysis was used. The software was used to analyze the correlation among the prognosis of septic shock patients and blood lactate and APACHE Ⅱ scores. Results The average concentration of arterial blood lactic acid in 189 patients in group A less than or equal to 3.0 mmol/L,and it was higher than 3.0 mmol/L in arterial blood in group B,APACHE Ⅱ score in group A was lower than that in group B( P<0.05). After active and effective treatment in our hospital,204 cases in the 225 patients with septic shock survived and 11 patients eventually died due to multiple organ failure. Arterial blood lactate and APACHEII scores in survival group were lower than those in death group( P<0.05). Pearson correlation analysis showed that the prognosis of septic shock patients was positively correlated with blood lactate and APACHE Ⅱ scores( P<0.05). Conclusions The results of blood lactic acid and APACHE Ⅱ scores are satisfactory in septic shock patients. They can evaluate the prognosis of patients and guide clinical treatment. It is worthy of popularization and application.更多还原