Janda A, Hagmüller G W, Denck H
Chirurg. 1984 Jul;55(7):469-73.
The diagnostic value of lactate in acute occlusion of intestinal vessels was investigated in two groups of patients: Group 1 included 86 patients with reconstructions of aorta and intestinal arteries: The lactate-concentrations measured during uncomplicated postoperative course over 24 hours remained within the normal range of 4.31 +/- 1.06 mmol/l. Only in 3 patients with acute postoperative occlusion of intestinal arteries, lactate rose to high pathologic levels up to 59.94 mmol/l. In 10 patients after reconstruction of acute mesenteric artery occlusion the postoperative lactate levels enforced the decision in 9 cases against and in one patient to second look operation. Group 2 included 36 patients with acute abdomen: In 18 patients with intestinal vascular occlusions the mean value of lactate was 7.45 +/- 2.86 mmol/l, in 18 patients without intestinal ischemia lactate was only 1.94 +/- 1.02 mmol/l. The statistical difference is significant. In summary, the results of this study document the reliable value of lactate for the diagnosis of acute occlusions of intestinal vessels during pre- and postoperative course.
第一组包括86例接受主动脉和肠动脉重建的患者:术后24小时内无并发症过程中测得的乳酸浓度保持在4.31±1.06 mmol/l的正常范围内。仅3例术后急性肠动脉闭塞患者的乳酸升至高达59.94 mmol/l的高病理水平。在10例急性肠系膜动脉闭塞重建术后的患者中,术后乳酸水平在9例中促使决定不进行二次探查手术,1例患者决定进行二次探查手术。第二组包括36例急腹症患者:18例肠血管闭塞患者的乳酸平均值为7.45±2.86 mmol/l,18例无肠缺血患者的乳酸仅为1.94±1.02 mmol/l。统计学差异显著。总之,本研究结果证明了乳酸在术前和术后过程中对急性肠血管闭塞诊断的可靠价值。