本文選題：乳酸清除率　切入點(diǎn)：中心靜脈血氧飽和度　出處：《中國感染與化療雜志》2014年06期

【摘要】：目的探討重癥肺炎患者早期動脈血乳酸清除率、中心靜脈血氧飽和度(ScvO2)的監(jiān)測價(jià)值。方法回顧性研究2012年1月—2013月12月56例重癥肺炎患者,入科即刻和6 h時(shí)測定動脈血乳酸濃度和早期ScvO2,計(jì)算6 h乳酸清除率,并進(jìn)行急性生理與慢性健康(APACHEⅡ)評分,根據(jù)APACHEⅡ評分將患者分為3組:10~20分組(A組),20~30分組(B組),≥30分組(C組),比較不同組別早期乳酸清除率和ScvO2的差別,并分析其與預(yù)后的關(guān)系。結(jié)果 1B組初始動脈血乳酸較A組高,C組初始動脈血乳酸較B組高,但組間差異均無統(tǒng)計(jì)學(xué)意義(均P0.05);2B組早期6 h乳酸清除率、ScvO2均較A組低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),C組早期6 h乳酸清除率、ScvO2均低于B組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3B組病死率高于A組,C組病死率高于B組,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05);4死亡組APACHEⅡ評分高于存活組,早期動脈血乳酸清除率和ScvO2水平低于存活組,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05);5APACHEⅡ評分與早期乳酸清除率呈顯著負(fù)相關(guān)(r=0.661,P0.01),與早期ScvO2水平呈顯著負(fù)相關(guān)(r=0.579,P0.01)。結(jié)論早期動脈血乳酸清除率及ScvO2水平是反映重癥肺炎患者病情嚴(yán)重程度和預(yù)測患者轉(zhuǎn)歸的參考指標(biāo)。
[Abstract]:Objective to investigate the monitoring value of early arterial lactate clearance rate and central venous oxygen saturation (scvO _ 2) in patients with severe pneumonia. Methods 56 patients with severe pneumonia from January 2012 to December 2013 were studied retrospectively. Arterial lactate concentration and early scvO _ 2 were measured immediately and 6 h after admission, the clearance rate of lactate was calculated at 6 h, and Apache 鈪，

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