【摘要】：目的急性顱腦外傷后,患者動脈血乳酸及乳酸清除率在一定程度上反應了病情嚴重程度。文中旨在探討動脈血乳酸及乳酸清除率在評估顱腦外傷患者預后的價值。方法回顧性分析南京軍區(qū)南京總醫(yī)院急診科2015年2月至2015年11月收治的顱腦外傷患者94例基本資料。在患者入院時立即進行GCS評分,動脈血乳酸、血壓、心率的測定,在入院6 h后再次測定動脈血乳酸濃度,計算其動脈血乳酸清除率。將所有患者分別按格拉斯哥昏迷評分分值分為輕度組(13~15分)、中度組(9~12分)和重度組(3~8分),并根據預后分為死亡組和存活組,分別比較各組的動脈血乳酸值及乳酸清除率。結果輕、中、重度3組動脈血乳酸濃度間差異有統(tǒng)計學意義(F=19.99,P0.01),且6 h乳酸清除率組間差異亦有統(tǒng)計學意義(F=6.21,P0.01)。死亡組的初始血乳酸濃度明顯高于存活組[(4.20±1.36)mmol/L vs(1.58±0.93)mmol/L],差異有統(tǒng)計學意義(t=-9.78,P0.01);死亡組的6 h乳酸清除率明顯低于存活組[(31.73±12.84)%vs(46.25±12.01)%],差異有統(tǒng)計學意義(t=4.55,P0.01)。結論在顱腦外傷的患者中,動脈血乳酸及6 h乳酸清除率可較好地評估患者的病情程度及預后,在臨床中具有重要應用價值。
[Abstract]:Objective to reflect the severity of acute craniocerebral injury in patients with acute craniocerebral injury. The purpose of this study was to evaluate the value of arterial lactate and lactate clearance rate in evaluating the prognosis of patients with craniocerebral trauma. Methods the data of 94 patients with craniocerebral trauma admitted from February 2015 to November 2015 in the emergency department of Nanjing General Hospital of Nanjing military region were retrospectively analyzed. GCS score, arterial blood lactic acid, blood pressure and heart rate were measured immediately after admission. Arterial blood lactate concentration was measured again 6 hours after admission, and the clearance rate of arterial blood lactic acid was calculated. According to Glasgow coma score, all patients were divided into mild group (1315 points), moderate group (9-12 points) and severe group (3-8 points). According to the prognosis, they were divided into death group and survival group. Results there were significant differences in arterial lactate concentration among the mild, moderate and severe groups (F _ (19. 9) P _ (0.01), and there was also a significant difference in the clearance rate of lactate at 6 hours (F _ (6.21) P _ (0.01). The initial lactate concentration in the death group was significantly higher than that in the survival group [(4.20 鹵1.36) mmol/L vs (1.58 鹵0.93) mmol/L], the difference was statistically significant (t = 9.78, P 0.01), and the 6-hour lactate clearance rate in the death group was significantly lower than that in the surviving group [(31.73 鹵12.84) vs (46.25 鹵12.01)%] (t 4.55, P 0.01). Conclusion in patients with craniocerebral trauma, the removal rate of arterial lactic acid and 6-hour lactate can evaluate the degree of illness and prognosis of the patients, and it is of great value in clinical application.
【作者單位】： 南方醫(yī)科大學金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)急救醫(yī)學科;
【基金】：國家自然科學基金(81401583) 中國急診醫(yī)師協(xié)會專項科研基金(R2014004) 全軍后勤面上項目(CNJ14L002)
【分類號】：R651.15

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