动态监测血乳酸在多脏器功能障碍综合征患者治疗中的指导意义

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Abstract Objective To investigate the significance of dynamic monitoring of blood lactic acid(LAC)in the treatment of multiple organ dysfunction syndrome(MODS).Methods 63 patients with MODS in the Intensive Care Unit of the First People′s Hospital of Lanzhou City treated from January 2015 to October 2016 were divided into experimental group and control group according to the monitoring of LAC or not.The supplementary liquid and vasoactive drugs were adjusted and the treatment was upgraded according to blood LAC level,CVP,ScvO2,MAP and urine volume on 32 cases in experimental group,but according to CVP,ScvO2,MAP and urine volume on 31 cases in control group only.The GCS, PaO2/FiO2,PAHR,bilirubin,Cr,PLT of two groups were recorded and scored for MODS severity on admission,24 hours, 48 hours and 72 hours after admission.WBC,PCT and APACHEⅡwere compared between two groups were on admission and 72 hours after admission.And MODS severity score,mechanical ventilation time,duration in intensive care unit and mortality were compared.Results WBC,PCT of the experimental group was significantly lower than that of the control group 72 hours after admission,and the difference was statistically significant(P＜0.01);APACHE,MODS score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant (P＜0.01);mechanical ventilation time,duration in intensive care unit of the experimental group was significantly shorter than that of the control group,and the difference was statistically significant(P＜0.01).Conclusion Dynamic monitoring of LAC and lactate clearance rate(LCR)has important guiding significance in the treatment of MODS,the index is stable,reliable and can shorten mechanical ventilation time and duration in intensive care unit.

Key words： Lactic acid Lactate clearance rate Multiple organ dysfunction syndrome Early goal directed therapy

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	Articles by authors
	LUAN Jing
	WANG Yan-zhen
	PU Yong-peng
	CHEN Wei
	HAN Xu
	BAN Li-hong

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LUAN Jing,WANG Yan-zhen,PU Yong-peng, et al. The significance of dynamic monitoring of blood lactic acid in the treatment of multiple organ dysfunction syndrome[J]. 中国当代医药, 2017, 24(1): 19-22.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2017/V24/I1/19

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