摘要
目的探讨动态监测血乳酸与小儿危重病例评分（PCIS）的相关性及临床意义。方法对77例患儿入住儿科重症监护病房（PICU）时立即进行PCIS，根据PCIS分为极危重组（23例）、危重组（32例）、非危重组（22例），以患儿住院28d是否存活分为死亡组（22例）和存活组（SS例），并检测其动脉血乳酸。比较各组间的乳酸监测指标、PCIS，进行相关性分析，及其与患儿预后的关系。结果极危重组入PICU时血乳酸[（5．28±3．69）mm01]L]、乳酸峰值[（8．54±4．32）mmol／L]明显高于危重组和非危重组（P〈0．05），而PCIS[（65．79±2．34）分]明显低于其他两组（P〈0．05）；死亡组PCIS低于存活组（P〈0．05），而入PICU时血乳酸水平和乳酸峰值高于存活组（P〈0．05或〈0．01）；PCIS与血乳酸水平呈负相关（P〈0．01）。结论血乳酸水平升高的危重症患儿，病情更重、预后更差，PCIS与血乳酸水平存在明显负相关，动态监测血乳酸水平是反映危重症患儿病情严重程度和预测患儿转归的较好指标。
Objective To explore the relationship between dynamic lactic acid monitoring and pediatric critical illness score （PCIS） and clinical significance. Methods PCIS of 77 critically ill children admitted into pediatric intensive care unit （PICU） were recorded after hospitalization. According to PCIS, all the children were divided into extremely critical group （23 cases）, critical group （32 cases）, non-critical group （22 cases）,according to prognosis,all the children were divided into surrival group （55 cases） and death group （22 cases）. Blood concentration of lactic acid were detected. Differences in their lactic acid indexes （including lactic acid level after admission to PICU, peak lactic acid level） and PCIS were compared, their correlation and prognosis of critid death group （22 cases） cally ill children were analyzed. Results Lactic acid level after admission to PICU [ （5.28 ± 3.69） mmol/L] and peak lactic acid level [ （8.54± 4.32） mmol/L] in extremely critical group were significantly higher than those in critical group and non-critical group （P 〈 0.05 ）, but PCIS [ （ 65.79 ±2.34 ） scores ] was significantly lower than that in critical group and non-critical group （P 〈 0.05）. Lactic acid indexes in death group were significantly higher than those in survival group （P 〈 0.05 or 〈 0.01 ）, but PCIS was significantly lower than that in survival group （P 〈 0.05 ）. PCIS was negative correlated with lactic acid level （P 〈 0.01 ）. Conclusions Critically ill children with elevated lactic acid indexes are worse and poorer prognosis. PCIS score can effectively evaluate children＇s condition and prognosis, and compared with lactic acid level linear correlation is existed. Dynamic lactic acid monitoring indexes are the good factors for the severe degree and predicting the prognosis of the critically ill children.
出处
《中国医师进修杂志》
2011年第33期11-13,共3页
Chinese Journal of Postgraduates of Medicine
关键词
乳酸
危重病
预后
Lactic acid
Critical illness
Prognosis
