摘要
目的观察早期连续性血液净化（CBP）对乳酸酸中毒患者的治疗效果。方法采用前瞻性随机对照研究方法，选择2010年1月至2012年4月重症监护病房（ICU）41例乳酸酸中毒患者，按完全随机化原则分成CBP组21例、对照组20例。治疗前及治疗12、24、72h时检测患者血气分析、血乳酸、血生化，应用急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分对患者进行评估，记录患者住ICU时间及28d病死率。结果两组治疗后血乳酸水平、APACHEⅡ评分均逐渐下降。CBP组治疗12、24、72h后血乳酸值（mmol／L）明显低于对照组（12h：8．23±3．94比12．47±4．62，24h：4．46±1．57比10．54±3．48，72h：2．69±1．03比5．74±1．56，均P〈0．01）；治疗12、24、72hAPACHEⅡ评分（分）均明显低于对照组（12h：18．23±5．85比21．64±5．38，24h：16．49±4．62比20．61±5．71，72h：11．54±3．67比16．02±4．34，均P〈0．05）；CBP组住ICU时间（d）明显短于对照组（6．58±3．45比11．65±4．94，P〈0．05），28d病死率明显低于对照组（23．8％比45．0％，P〈0．05）。结论早期CBP治疗乳酸酸中毒患者能够减少病死率。
Objective To observe the therapeutic effect of early continuous blood purification （CBP） on lactic acidosis patients. Methods Using prospective randomized study method, 41 patients with lactic acidosis in intensive care unit （ICU） from January 2010 to April 2012 were randomly divided into CBP group （n=21） and control group （n=20）. Among them, blood gas analysis, lactic acid, blood biochemistry were prospectively monitored at the time before treatment, 12, 24 and 72 hours after treatment. They were also evaluated with acute physiology and chronic health evaluation Ⅱ （APACHEⅡ ） score, and length of stay in ICU and mortality in 28 days were recorded. Results Lactic acid level and APACHE Ⅱ score were gradually decreased after treatment in both groups. Compared with control group, lactic acid （mmol/L） at 12, 24 and 72 hours in CBP group was obviously lowered （ 12 hours： 8.23 ± 3.94 vs. 12.47 ± 4.62, 24 hours： 4.46 ± 1.57 vs. 10.54 ±3.48, 72 hours： 2.69 ± 1.03 vs. 5.74 ± 1.56, all P〈0.01）, while the APACHE Ⅱ score at 12, 24 and 72 hours in CBP group was also significantly lowered （12 hours： 18.23 ± 5.85 vs. 21.64 ±5.38, 24 hours： 16.49 ±4.62 vs. 20.61 ±5.71, 72 hours： 11.54 ±3.67 vs. 16.02 ±4.34, all P〈0.05）. Compared with control group, length of stay in ICU （days） was also significantly shorter in CBP group （6.58 ± 3.45 vs. 11.65 ± 4.94, P〈0.05）, and 28-day mortality was significantly lower in CBP group （23.8% vs. 45.0%, P〈0.05）. Conclusion Early correction of lactic acidosis with CBP could reduce the mortality of lactic acidosis.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2013年第1期45-47,共3页
Chinese Critical Care Medicine
基金
广东省汕头市重点科技计划项目（201146-17）
关键词
早期
连续性血液净化
乳酸酸中毒
病死率
Early stage
Continuous blood purification
Lactic acidosis
Mortality
