目的 探討早期堿剩余對感染性休克患者病情嚴(yán)重程度的預(yù)測價(jià)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(jìn)行回顧性分析，按死亡及存活進(jìn)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(jìn)行對照研究。 結(jié)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(dá)92.23%。 結(jié)論 早期堿剩余有助于感染性休克預(yù)后評估和指導(dǎo)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(yán)重程度預(yù)測價(jià)值. 華西醫(yī)學(xué), 2012, 27(10): 1483-1486. doi: 復(fù)制
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| 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(yán)重膿毒癥預(yù)后的臨床價(jià)值研究[J]. 中國實(shí)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(fù)蘇的臨床反應(yīng)性評價(jià)[J].華西醫(yī)學(xué), 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. |
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| 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(yè), 吳河水, 吳雙華, 等. 堿剩余早期動(dòng)態(tài)變化與嚴(yán)重膿毒癥和膿毒癥休克患者預(yù)后的關(guān)系[J]. 中國急救醫(yī)學(xué), 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(yán)重膿毒癥預(yù)后的臨床價(jià)值研究[J]. 中國實(shí)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(fù)蘇的臨床反應(yīng)性評價(jià)[J].華西醫(yī)學(xué), 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(yè), 吳河水, 吳雙華, 等. 堿剩余早期動(dòng)態(tài)變化與嚴(yán)重膿毒癥和膿毒癥休克患者預(yù)后的關(guān)系[J]. 中國急救醫(yī)學(xué), 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.