摘要
目的探讨动态监测血乳酸水平对感染性休克患儿病情严重程度和预后的评估价值。方法将我院收治的95例感染性休克患儿纳入研究,以入院确诊后为研究起点,动态监测0、6、12、24 h血乳酸水平,记录6 h乳酸清除率和24 h小儿危重病例评分(PCIS),按PCIS评分分为轻度组(>70分,40例)、中度组(60~70分,38例)和重度组(<60分,17例),按6h乳酸清除率分为高乳酸清除率组(≥10%,66例)和低乳酸清除率组(<10%,29例),按预后不同分为存活组(56例)和死亡组(39例),比较各组各时间点血乳酸水平、PCIS评分和6 h乳酸清除率,并分析各指标间的关系。结果轻、中、重度3组间各时间点血乳酸水平、6 h乳酸清除率及病死率比较,差异有统计学意义(P<0.05);轻度组血乳酸水平低于中、重度组(P<0.05),6 h乳酸清除率高于中、重度组(P<0.05);中度组血乳酸水平低于重度组(P<0.05),6 h乳酸清除率高于重度组(P<0.05);轻、中度组病死率低于重度组(P<0.05);高乳酸清除率组各时间点血乳酸水平和死亡率均低于低乳酸清除率组(P<0.05);PCIS评分高于低乳酸清除率组(P<0.05);存活组各时间点血乳酸水平均低于死亡组(P<0.05),6 h乳酸清除率和PCIS评分均高于死亡组(P<0.05);PCIS评分与0、6、12、24 h血乳酸水平均呈负相关(P<0.05),与6 h乳酸清除率呈正相关(P<0.05)。结论在评估感染性休克患儿的病情严重程度和预后方面,动态监测血乳酸水平具有重要临床意义。
Objective To explore dynamic monitoring on severity and prognostic value of blood lactate level of children with septic shock.Methods 95 cases with septic shock treated in our hospital were included in the study.The diagnosis after admission was taken as the starting point for the study,and the blood lactate levels at 0,6,12 and 24 h were dynamically monitored,and the 6 h lactate clearance rate and the 24 h pediatric critical illness score(PCIS)were recorded.According to the PCIS score,the patients were divided into mild group(>70 points,40 cases),moderate group(60~70 points,38 cases)and severe group(<60 points,17 cases),moreover,they were divided into high lactate clearance rate group(≥10%,66 cases)and low lactate clearance rate group(<10%,29 cases)according to the 6 h lactate clearance rate.According to the different prognosis,they were divided into survival group(56 cases)and death group(39 cases),and the blood lactate level,PCIS score and 6 h lactate clearance rate among these groups were compared at each time point,and the relationship among the indexes was analyzed.Results There were statistically significant differences in the blood lactate level,6 h lactate clearance rate and mortality rate among the mild,moderate and severe groups(P<0.05);the blood lactate level in the mild group was lower than that in the moderate and severe groups(P<0.05),while the 6 h lactate clearance rate was higher than that in the moderate and severe groups(P<0.05),the blood lactate level in the moderate group was lower than that in the severe group(P<0.05),while the 6 h lactate clearance rate was higher than that in the severe group(P<0.05),the mortality rate in the mild and moderate groups was lower than that in the severe group(P<0.05),the blood lactate level and mortality rate in high lactate clearance rate group at each time point were lower than those in low lactate clearance rate group(P<0.05),PCIS score in high lactate clearance rate group was higher than that in low lactate clearance rate group(P<0.05),the blood lactate
作者
伊滨滨
Yi Binbin(Department of Pediatrics,the People's Hospital of Hebi,Hebi 358030 China)
出处
《锦州医科大学学报》
CAS
2019年第6期35-38,共4页
Journal of Jinzhou Medical University
基金
2018年度河南省医学科技公关普通项目，项目编号:2018020642
关键词
动态监测
血乳酸
感染性休克
儿童
预后
dynamic monitoring
blood lactate
septic shock
children
prognosis
