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透过现象看乳酸与危重患者的氧代谢障碍
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Tuberculosis and Respiratory Diseases
- Issue:
- 11
- DOI:
- 10.3760/cma.j.issn.1001-0939.2014.11.002
- Key Word:
- No keyword available
Abstract： 血乳酸浓度升高是危重患者常见的临床现象,高乳酸血症可以作为判断患者预后的重要指标,并可以反应重症患者早期器官功能障碍[1-2],因此血乳酸浓度也成为重症患者重要监测指标.但是最近有系统综述提出危重患者的血乳酸浓度并不能特异反映其预后[3],这样的结果似乎与近年来乳酸清除率这一概念提出的背景相吻合.乳酸清除率是机体在特定时间内清除乳酸的能力.有研究结果证实,乳酸清除率较血乳酸浓度监测对预后的判断更具有特异性,尤其对于危重患者早期.如脓毒症第一个6h的乳酸清除率＞36％被认为是预后良好的指标[4-5].以乳酸清除率作为目标的指导性治疗,对于降低脓毒症患者28 d病死率更具意义[6].
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