[动脉血乳酸动态监测在心脏手术预后中的应用]
[Dynamic monitoring of arterial blood lactic acid in the prognosis of heart operation].
作者信息
Li Ping, Yuan Dun, Luo Wan-Jun
机构信息
Department of Cardiothoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2008 Dec;33(12):1154-7.
OBJECTIVE
To determine the clinical value of arterial blood lactic acid monitoring in patients after cardiac surgery.
METHODS
Relationship between dynamic blood lactic acid level and the prognosis of 200 patients (9 patients in the dead group, and 191 patients in the healing group) was analyzed after cardiac operation.
RESULTS
The level of blood lactic acid was (1.2+/-0.3) mmol/L in the healing group,and (5.6+/-0.9) mmol/L in the death group. The level of blood lactic acid in the healing group descended to normal in 24 hours, while that in the death group rose persistently. The dynamic change of lactic acid indicated more sensitively the prognosis of the disease than pH and BE.
CONCLUSION
The higher the arterial blood level of lactic acid, the longer the duration, the more critical the condition, the higher the mortality rate. Blood lactic acid level can be used as an excellent prognosis index for patients after cardiac surgery.
目的
确定动脉血乳酸监测在心脏手术后患者中的临床价值。
方法
分析200例心脏手术后患者（死亡组9例，康复组191例）动态血乳酸水平与预后的关系。
结果
康复组血乳酸水平为（1.2±0.3）mmol/L，死亡组为（5.6±0.9）mmol/L。康复组血乳酸水平在24小时内降至正常，而死亡组则持续上升。乳酸的动态变化比pH值和碱剩余更敏感地反映疾病预后。
结论
动脉血乳酸水平越高、持续时间越长、病情越严重、死亡率越高。血乳酸水平可作为心脏手术后患者良好的预后指标。
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