摘要
目的:探讨乳酸在恶性肿瘤患者术后感染中的预后评估价值。方法:回顾性分析2014年1月至2016年12月期间收治的83例恶性肿瘤术后出现感染及感染性休克患者的临床资料,依据28d治疗结局分为存活组(47例)和死亡组(36例),比较两组患者的初始乳酸水平、复查的乳酸清除率和急性生理与慢性健康评分Ⅱ(APACHEⅡ)的差异;并按初始乳酸水平将患者分成四组(初始乳酸水平<2mmoL/L,2~4mmoL/L,4~10mmoL/L及≥10mmoL/L),比较不同初始乳酸水平患者的预后情况,评估乳酸在恶性肿瘤患者术后感染中的预后评估价值。结果:存活组与死亡组患者初始乳酸水平、复查的乳酸水平及乳酸清除率分别为(2.54±1.69,3.62±3.17)、(1.78±1.43,2.70±2.69)、(24.02±32.79,11.31±54.71),两组比较,P值均<0.05,差异有统计学意义;乳酸水平<2mmoL/L,2~4mmoL/L,4~10mmoL/L及≥10mmoL/L时患者的死亡率分别为35.48%、43.33%、50%、100%。结论:初始乳酸水平可用于判断恶性肿瘤术后出现感染及感染性休克患者的病情,初始乳酸水平越高,患者病情越重,预后越差;复查的乳酸清除率较高的患者死亡率较低,乳酸监测可用于评估患者病情及预后。
Objective:To evaluate the prognostic value of lactic acid in patients with malignant tumors after surgical infection.Methods:The clinical data of 83 patients with infection and septic shock after operation of malignant tumors admitted from January 2014 to December 2016 were retrospectively analyzed.According to the outcome of 28 days treatment,the patients were divided into survival group(47 cases)and death group(36 cases).The differences of initial lactate level,lactate clearance rate and acute physiology and chronic health score II(APACHE II)between the two groups were compared.The patients were divided into four groups according to the initial lactate level(initial lactate level<2 mmoL/L,2~4 mmoL/L,4~10 mmoL/L and≥10 mmoL/L).The prognosis of patients with different initial lactate levels was compared and the prognostic evaluation value of lactate in patients with malignant tumors after infection was evaluated.Results:The initial lactate level,the rechecked lactate level and the lactate clearance rate of survival group and death group were(2.54±1.69),3.62±3.17),(1.78±1.43),2.70±2.69),(24.02±32.79),11.31±54.71),respectively.The P values of both groups were<0.05,with significant difference.The mortality rates were 35.48%,43.33%,50% and 100% when the lactate level was less than 2 mmoL/L,2~4 mmoL/L,4~10 mmoL/L and more than 10 mmoL/L,respectively.Conclusion:Initial serum lactate can be used to assess the severity of the postoperative-infection patients with tumor.The higher of the initial Serum lactate level,the more serious of the disease,and the worse prognosis of the patients.And the higher of the reviewal lactate clearance rate,the lower mortality of the patients.lactate monitoring can be used to evaluate the prognosis of postoperative-infection patients with tumor.
作者
邵丽娜
吴兵
郑振
SHAO Lina(The Cancer Hospital of China Medical University/The Tumor Hospital ofLiaoning PRovince,Liaoning Shenyang 110042,China)
出处
《河北医学》
CAS
2019年第1期34-37,共4页
Hebei Medicine
