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目的探讨血乳酸水平的动态监测在脓毒症患儿的病情评估与预后判断中的临床意义。方法动态监测51例脓毒症患儿入住ICU时、入院后24、48、72h的血清乳酸变化,比较脓毒症组与对照组、有多器官功能障碍(MODS)组与无MODS组、存活组与死亡组之间的血乳酸水平。结果脓毒症组血乳酸水平明显高于对照组(P<0.001);有MODS组血乳酸明显高于无MODS组(P<0.001);死亡组血乳酸水平高于存活组(P<0.001),存活组患儿经治疗后血乳酸水平逐步下降,并于48h内恢复正常,而死亡组患儿经治疗后血乳酸水平未见下降,且持续升高,与存活组患儿比较差异有统计学意义。结论早期常规动态监测脓毒症患儿的血乳酸水平变化有利于患儿的病情评估、疗效评价及预后判断。
Objective To investigate the clinical significance of dynamic monitoring of blood lactate levels in the evaluation and prognosis of sepsis in children. Methods Dynamic changes of serum lactic acid in 51 sepsis children admitted to ICU at 24, 48 and 72 h after admission were compared between sepsis group and control group, multiple organ dysfunction (MODS) group and no MODS group Blood lactate levels between the group and the death group. Results Serum levels of lactic acid in sepsis group were significantly higher than those in control group (P <0.001). Blood lactic acid in MODS group was significantly higher than that in non-MODS group (P <0.001) , The level of blood lactate in survivors decreased gradually after treatment and returned to normal within 48 hours, but the blood lactate levels did not decrease and persistently increased in survivors after treatment Significance of learning. Conclusion Early routine dynamic monitoring of blood lactic acid levels in children with sepsis is conducive to the assessment of the disease in children, evaluation of the efficacy and prognosis.