腹部大手术后动脉血乳酸水平对临床结果的影响

目的:研究腹部大手术后动脉血乳酸水平对临床结果的影响.方法:对2007年2月～2009年2月所有进行腹部大手术的421例病例进行前瞻性对比研究,统计所有病人的初始、第24小时、第48小时乳酸值及清除时间,并发症及死亡情况.结果:并发症组及死亡组术后不同时间血乳酸水平均高于无并发症组(P<0.001);术后乳酸值24小时正常组、24～48小时正常组、48小时后正常组及术后乳酸一直未正常组并发症发生率分别为13%、39%、65%和100%.结论:动脉血乳酸水平可预测腹部大手术后并发症发生率及死亡率.

Effect of Serum Lactate on Outcome of Patients Undergoing Major Abdominal Surgery

Objective:To examine the effect of serum lactate on the outcome of patients undergoing major abdominal surgery.Methods:A propective and controlled study was perfomed on 421 cases undergoing abdominal surgery from Feb.2007 to Feb.2009.Initail,24-hour,48-hour lactate and time of lactate clearance was record,as well as complication and death.Results:Initial lactate level was significantly higher in patients with postoperative complications and group of death than those without complications(P < 0.05).If postoperative lactate normalized within 24 hours the incidence of complications was 13 %,compared with 39 % for 24 ～ 48 hours and 65 % for > 48 hours and 100 % if lactate failed to normalize.Conclusion:Serum lactate may predict the mortality and incidence of complications after major abdominal surgery.