摘要

目的：探讨APACHEⅡ评分、血乳酸清除率对危重症患者的预后评估比较。方法：临床上选取146例危重患者,按照APACHEⅡ评分高低分为A、B、C组,评估各组血乳酸清除率、APACHEⅡ评分;将患者分为死亡组和存活组,评估血乳酸清除率、APACHEⅡ评分。结果：146例危重患者中死亡23例(15.8%),存活123例(84.2%)。B、C两组血乳酸水平明显高于A组,血乳酸清除率明显低于A组,P〈0.01,具有统计学意义;C组血乳酸水平明显高于B组,血乳酸清除率明显低于B组P〈0.05,具有统计学意义;A、B、C组24h血乳酸水平都比即时血乳酸水平低,P〈0.05,具有统计学意义;APACHEⅡ分值的增加患者血乳酸清除率在减小,P〈0.05,具有统计学意义;死亡组的APACHEⅡ评分明显高于存活组,P〈0.05,具有统计学意义;两组24h血乳酸水平都比即时血乳酸水平低,P〈0.05,具有统计学意义。结论：通过检测血乳酸水平和APACHEⅡ评分的方法能够很好地评估危重患者的患病情况,利于医生对患者的治疗,从而降低患者的死亡率。

Objective： To discuss the action of APACHE Ⅱscore,blood lactate clearance rate on comparison prognosis of critically ill patients. Method： 146 cases of critically ill patients were selected and divided into group A,B,C according to the level of APACHE Ⅱ score,each group were assessed blood lactate clearance rate,APACHE Ⅱ score; patients were divided into groups of death and survival group,and then assess blood lactate clearance rate,APACHE Ⅱ score.Result： 23 cases of 146 cases of death in critically ill patients( 15.8%),123 cases survived( 84.2%). Blood lactic acid level two groups B,C was higher than that in group A,the blood lactate clearance rate was significantly lower than that in group A,P 0.01,has statistical significance; group C blood lactate levels were significantly higher than that of group B,the blood lactic acid clearance rate was significantly lower in group B( P 0. 05),with statistical significance;group A,B,C blood lactate levels with 24 h the instant blood lactic acid level was low,P 0.05,with statistical significance; increase the APACHE II score of patients with blood lactate clearance rate decreases,P 0.05,with statistical significance; the death group APACHE II score was significantly higher than the survival group,P 0.05,has statistical significance; 24 h blood lactic acid levels in the two groups than the instant blood lactic acid level is low,P 0.05,the statistical significance.Conclusion： By detecting the blood lactic acid level and APACHE II score well able to assess the prevalence of critically ill patients to the doctor,treatment of patients,so as to reduce the mortality of patients.