论文部分内容阅读
目的探讨早期乳酸清除率对重度窒息新生儿预后的临床价值。方法对2008年1月-2009年12月东南大学附属中大医院新生儿重症监护病房收治的77例重度窒息新生儿入院时行新生儿危重病例评分(NCIS)及动脉血乳酸水平测定,治疗6 h后再次行血乳酸测定,计算治疗后6 h乳酸清除率,并将患儿分为存活组(58例)和死亡(含放弃)组(19例);高乳酸清除率组(61例)和低乳酸清除率组(16例),比较其上述指标的差异。应用SPSS 13.0软件进行数据处理。结果各组胎龄、性别、入院时日龄、出生体质量比较,差异均无统计学意义(Pa>0.05)。存活组、死亡组患儿治疗前动脉血乳酸水平分别为(7.5±3.9)mmol.L-1及(8.1±5.0)mmol.L-1,NCIS分别为(71.2±8.7)分及(69.7±10.9)分,差异均无统计学意义(Pa>0.05)。存活组6 h乳酸清除率(50.1±21.0)%,死亡组6 h乳酸清除率(12.3±23.8)%,差异有统计学意义(P<0.05)。高乳酸清除率组和低乳酸清除率组治疗前动脉血乳酸水平分别为(7.7±3.8)mmol.L-1及(8.3±5.4)mmol.L-1,NCIS评分分别为(70.7±11.2)分及(68.6±10.9)分,差异均无统计学意义(Pa>0.05)。高乳酸清除率组病死率为13.1%,低乳酸清除率组的病死率为68.8%,差异有统计学意义(P<0.05)。结论早期乳酸清除率可用于评估重度窒息新生儿的预后。
Objective To investigate the clinical value of early lactic acid clearance in prognosis of severe asphyxia neonates. Methods From January 2008 to December 2009, 77 neonates with severe asphyxia admitted to the Neonatal Intensive Care Unit of the Affiliated Zhongda Hospital of Southeast University were enrolled in the neonatal critical illness score (NCIS) and arterial blood lactate levels. Treatment 6 Blood lactate was measured again after 6 h, and the lactic acid clearance rate was calculated at 6 h after treatment. The children were divided into survivor group (n = 58) and death group (n = 19). The high lactic acid clearance group (n = 61) And low lactic acid clearance group (16 cases), compare the differences of the above indexes. Application SPSS 13.0 software for data processing. Results There was no significant difference in gestational age, sex, age at admission, body mass at birth between the two groups (Pa> 0.05). The arterial blood lactic acid levels in survivors and death patients before treatment were (7.5 ± 3.9) mmol.L-1 and (8.1 ± 5.0) mmol.L-1, respectively. The NCIS were 71.2 ± 8.7 and 69.7 ± 10.9) points, the difference was not statistically significant (Pa> 0.05). The lactic acid clearance rate (50.1 ± 21.0)% in the surviving group at 6 h and the lactic acid clearance rate (12.3 ± 23.8)% in the dead group at 6 h were significantly different (P <0.05). The arterial blood lactic acid levels before and after treatment were (7.7 ± 3.8) mmol.L-1 and (8.3 ± 5.4) mmol.L-1, respectively. The NCIS scores were (70.7 ± 11.2) Points and (68.6 ± 10.9) points, the difference was not statistically significant (Pa> 0.05). The case fatality rate was 13.1% in the high lactic acid clearance group and 68.8% in the low lactic acid group, the difference was statistically significant (P <0.05). Conclusion Early lactate clearance can be used to assess the prognosis of severe asphyxia neonates.