早期堿剩余對感染性休克患者的病情嚴重程度預測價值_《華西醫學》

作者：

楊明全 , 陳燕梅

自貢市第一人民醫院重癥醫學科（四川自貢，643000）;

關鍵詞：

感染性休克堿剩余病情程度預后

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目的　探討早期堿剩余對感染性休克患者病情嚴重程度的預測價值。方法　對2009年2月－2011年2月資料完整入院的感染性休克患者60例進行回顧性分析，按死亡及存活進行分組，對最初24 h的堿剩余值差異及血乳酸清除率情況進行對照研究。結果　死亡組堿剩余值變化及乳酸清除率低于存活組（P＜0.05）。治療后堿剩余≤?6 mmol/L較堿剩余＞?6 mmol/L的患者病死率明顯增加，尤其是治療后24 h 堿剩余仍≤?6 mmol/L病死率高達92.23%。結論　早期堿剩余有助于感染性休克預后評估和指導臨床治療。

引用本文： 楊明全,陳燕梅. 早期堿剩余對感染性休克患者的病情嚴重程度預測價值. 華西醫學, 2012, 27(10): 1483-1486. doi: 復制

1.	Levy MM, Dellinger RP, Townsend SR, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis[J]. Intensive Care Med, 2010，36(2): 222-231.
2.	American College of Chest Physiciana/Society of Critical Care Medicine Consensus Confeernce. Definitionsforse psisa ndorgan failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6): 864-874.
3.	Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008[J]. Crit Care Med, 2008, 36(1): 296-327.
4.	Lee SW, Hong YS, Park DW, et al. Lactic acidosis not hyperlactatemia as a predictor of inhospital mortality in septic emergency patients[J]. Emerg Med J, 2008, 25(10): 659-665．.
5.	Gunnerson KJ, Saul M, He S, et al. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients[J]. Crit Care, 2006, 10(1): R22.
6.	Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial[J]. JAMA, 2010, 303(8): 739-746.
7.	徐向東, 吳健鋒, 管向東, 等. 早期乳酸清除率評估外科嚴重膿毒癥預后的臨床價值研究[J]. 中國實用外科雜志, 2007, 27(12): 969-970．.
8.	楊明全, 曹建偉, 陳燕梅. 膿毒性休克早期液體復蘇的臨床反應性評價[J].華西醫學, 2011, 26(6): 863-866.
9.	Palma LC, Ferreira GF，Amaral ACKB，et al．Acidosis and mortality in severe sepsis and septic shock evaluated by base excess variation [J]．Critical Care, 2003, 7(Suppl 3): 39.
10.	Allen M. Lactate and acid base as a hemodynamic monitor and markers of cellular perfusion[J]. Pediatr Crit Care Med, 2011, 12(4 Suppl): S43- S49.
11.	Surbatovic M, Radakovic S, Jevtic M, et al. Predictive value of serum bicarbonate, arterial base deficit/excess and SAPSⅢ score in critically ill patients[J]. Gen Physiol Biophys, 2009, 28: 271-276.
12.	Noritomi DT, Soriano FG, Kellum JA, et al. Metabolic acidosis in patients with severe sepsis and septic shock: a longitudinal quantitative study[J]. Crit Care Med, 2009, 37(10): 2733-2739.
13.	Park M, Azevedo LC, Maciel AT, et al. Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers[J]. Clinics (Sao Paulo), 2006, 61(1): 47-52.
14.	潘景業, 吳河水, 吳雙華, 等. 堿剩余早期動態變化與嚴重膿毒癥和膿毒癥休克患者預后的關系[J]. 中國急救醫學, 2009, 29(2): 100-102.
15.	Montassier E, Batard E, Segard J, et al. Base excess is an accurate predictor of elevated lactate in ED septic patients[J]. Am J Emerg Med, 2012, 30(1): 184-187.

1. 　Levy MM, Dellinger RP, Townsend SR, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis[J]. Intensive Care Med, 2010，36(2): 222-231.
2. 　American College of Chest Physiciana/Society of Critical Care Medicine Consensus Confeernce. Definitionsforse psisa ndorgan failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6): 864-874.
3. 　Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008[J]. Crit Care Med, 2008, 36(1): 296-327.
4. 　Lee SW, Hong YS, Park DW, et al. Lactic acidosis not hyperlactatemia as a predictor of inhospital mortality in septic emergency patients[J]. Emerg Med J, 2008, 25(10): 659-665．.
5. 　Gunnerson KJ, Saul M, He S, et al. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients[J]. Crit Care, 2006, 10(1): R22.
6. 　Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial[J]. JAMA, 2010, 303(8): 739-746.
7. 　徐向東, 吳健鋒, 管向東, 等. 早期乳酸清除率評估外科嚴重膿毒癥預后的臨床價值研究[J]. 中國實用外科雜志, 2007, 27(12): 969-970．.
8. 　楊明全, 曹建偉, 陳燕梅. 膿毒性休克早期液體復蘇的臨床反應性評價[J].華西醫學, 2011, 26(6): 863-866.
9. 　Palma LC, Ferreira GF，Amaral ACKB，et al．Acidosis and mortality in severe sepsis and septic shock evaluated by base excess variation [J]．Critical Care, 2003, 7(Suppl 3): 39.
10. 　Allen M. Lactate and acid base as a hemodynamic monitor and markers of cellular perfusion[J]. Pediatr Crit Care Med, 2011, 12(4 Suppl): S43- S49.
11. 　Surbatovic M, Radakovic S, Jevtic M, et al. Predictive value of serum bicarbonate, arterial base deficit/excess and SAPSⅢ score in critically ill patients[J]. Gen Physiol Biophys, 2009, 28: 271-276.
12. 　Noritomi DT, Soriano FG, Kellum JA, et al. Metabolic acidosis in patients with severe sepsis and septic shock: a longitudinal quantitative study[J]. Crit Care Med, 2009, 37(10): 2733-2739.
13. 　Park M, Azevedo LC, Maciel AT, et al. Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers[J]. Clinics (Sao Paulo), 2006, 61(1): 47-52.
14. 　潘景業, 吳河水, 吳雙華, 等. 堿剩余早期動態變化與嚴重膿毒癥和膿毒癥休克患者預后的關系[J]. 中國急救醫學, 2009, 29(2): 100-102.
15. 　Montassier E, Batard E, Segard J, et al. Base excess is an accurate predictor of elevated lactate in ED septic patients[J]. Am J Emerg Med, 2012, 30(1): 184-187.

《華西醫學》

早期堿剩余對感染性休克患者的病情嚴重程度預測價值

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《華西醫學》

早期堿剩余對感染性休克患者的病情嚴重程度預測價值

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料