Objective:To discuss the effects of early lactate clearance rate on the prognosis of patients with severe sepsis and septic shock. Methods:The lactic acid levels in 112 patients with severe sepsis and septic shock were measured at admission and at 6 hours of admission,and the lactate clearance rates of all cases were calculated. All patients were divided into the high lactate clearance rate group( the lactate clearance rate more than 10%) and low lactate clearance rate group( the lactate clearance rate less than 10%) . The mortality,initial level of lactic acid and APACHE Ⅱ score between two groups were compared. All patients were followed up for 30 days,and divided into the survival group and death group according to their survival. The arterial blood lactate level, early lactate clearance rate and APACHE Ⅱ score between two groups were compared. Results:The difference of the initial level of lactic acid between the high lactate clearance rate group and low lactate clearance rate group was statistically significant(P10%)组和低乳酸清除率(乳酸清除率≤10%)组,比较2组病死率、初始乳酸水平和APACHEⅡ评分.随访30 d,根据患者生存情况将患者分为存活组和死亡组,比较2组动脉血乳酸水平、早期乳酸清除率及APACHEⅡ评分.结果:高乳酸清除率组和低乳酸清除率组初始乳酸水平差异有统计学意义(P<0.01).高乳酸清除率组病死率和APACHEⅡ评分均明显低于低乳酸清除率组(P<0.01),随访30 d后,病死45例,存活67例,存活组APACHEⅡ评分明显低于病死组(P<0.01).存活组早期乳酸清除率明显高于病死组(P<0.01).结论:早期乳酸清除率可以作为判断严重脓毒症及脓毒性休克患者预后的一个重要指标.
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