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目的 :探讨血浆乳酸浓度在评价重症感染合并多脏器功能不全综合征 (MODS)中的意义。方法 :按MODS病情严重程度 ,将患者分为A、B、C三组 ,测定其血浆乳酸浓度、血气分析及动脉血清酮体比值 (AKBR)等指标 ,动态监测B组和C组患者入院当日、第三日、第五日及病情变化时的血浆乳酸浓度、血气分析及AKBR等指标。结果 :A、B、C三组血浆乳酸浓度均高于正常对照组 ,血浆乳酸浓度与病情严重程度APACHEⅢ评分、AKBR、PH值、剩余碱(BE)及PaO2 之间无明显相关性 (r>0 0 5 ,P >0 0 5 )。结论 :血浆乳酸浓度的升高并不一定代表细胞内缺氧 ,在评价组织氧合状态和细胞受损时需要动态监测 ,并且应结合患者病情及其它反映机体氧合状态的指标综合判断
Objective: To investigate the significance of plasma lactate concentration in the evaluation of severe infection complicated with multiple organ dysfunction syndrome (MODS). Methods: According to the severity of MODS, the patients were divided into three groups: A, B and C, and their plasma lactate concentration, blood gas analysis and arterial serum ketone ratio (AKBR) were measured. On the day of admission, patients in groups B and C , The third day, the fifth day and changes in the condition of plasma lactate concentration, blood gas analysis and AKBR and other indicators. Results: The levels of plasma lactic acid in group A, B and C were higher than those in normal control group. There was no significant correlation between plasma lactic acid concentration and APACHE Ⅲ score, AKBR, PH, residual base (BE) and PaO2 (r> 0 0 5, P> 0 0 5). Conclusion: The increase of plasma lactate concentration does not necessarily represent intracellular hypoxia. It is necessary to dynamically monitor the oxygenation status and cellular damage in tissue and should be combined with the patient’s condition and other indicators that reflect the oxygenation status of the body