Abstract：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.
邵丽娜, 吴兵, 郑振. 乳酸在恶性肿瘤患者术后感染中的预后评估价值[J]. 河北医学, 2019, 25(1): 34-36.
SHAO Lina, et al. Prognostic Value of Lactic Acid in Patients with Malignant Tumors after Surgical Infection. HeBei Med, 2019, 25(1): 34-36.
[1] Yealy DM, Kellum JA, Huang DT, et al.A randomized trial of protocol-based care for early septic shock[J].N Engl Med,2014,370(18):1683~1693. [2] Peake SL, Delaney A, Bailey M, et al.Goal-directed resuscitation for patients with early septic shock[J].N Engl Med,2014,371(16):1496~1506. [3] Mouncey PR, Osborn TM, Power GS, et al.Trial of early, goal-directed resuscitation for septic shock[J].N Engl Med,2015,72(14):1301~1311. [4] A. Hiong, K. A. Thursky, B. W. Teh, et al.Sepsis following cancer surgery: the need for early recognition and standardised clinical care[J].Expert Review of Anti-infective Therapy,2016,14(4):425~433. [5] Dellinger RP, Levy MM, Rhodes A, et al.Surviving sepsis campaign:international guidelines for management of severe sepsis and septic shock[J].Crit Care Med,2013,41(2):580~637. [6] 吴兵,邵丽娜.乳酸及早期乳酸清除率对肿瘤相关复杂腹腔感染患者预后的评估价值[J].肿瘤学杂志,2018,24(1):55~57. [7] Kimberly A,Chambers, Adam Y,et al.Outcomes of severe sepsis and septic shock patients after stratification by initial lactate value[J].World Emerg Med,2018,9(2):113~117.
2019, Vol. 25 
冀公网安备13080202000677号