Đánh giá sự thay đổi và giá trị tiên lượng của lactat máu ở bệnh nhân chấn thương nặng=Evaluate the variation and prognostic value of lactate in treating severe trauma patients

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Văn Đồn Trịnh, Thị Kiều Anh Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.176-183

Bộ sưu tập: Metadata

ID: 477576

Thêm vào giỏ

Nghiên cứu nhằm đánh giá sự thay đổi và mối liên quan của lactat máu với đặc điểm lâm sàng, cận lâm sàng cũng như trong tiên lượng điều trị ở bệnh nhân chấn thương nặng. Phương pháp nghiên cứu: Nghiên cứu tiến cứu mô tả trên 187 bệnh nhân chấn thương nặng tại Bệnh viện Hữu Nghị Việt Đức từ 01/ 2020 đến 10 /2020. Tất cả bệnh nhân (BN) được máu động mạch làm xét nghiệm lactat máu và một số thông số lâm sàng và cận lâm sàng đánh giá tại 4 thời điểm: T0, T1, T2, T3 tương ứng với: Khi vào viện, 6 giờ, 24 giờ và 48 giờ sau vào viện. Kết quả nghiên cứu: Lactat máu cao nhất ở thời điểm ban đầu, giảm dần theo các thời điểm nghiên cứu
lactat máu ban đầu, 6 giờ, 24 giờ sau vào viện có tương quan đồng biến chặt chẽ với điểm ISS với r0 = 0,702, r1 = 0,648, r2 = 0,513
lactat máu tại tất cả các thời điểm nghiên cứu có tương quan đồng biến chặt chẽ với điểm SOFA với r0 = 0,776, r1 = 0,714, r2 = 0,627, r3 = 0,604
lactat máu ban đầu có hiệu lực tiên lượng tử vong tốt với AUC = 0,896, điểm giá trị cắt tiên lượng tử vong của lactat là 5,9 mmol/l với độ nhạy 78,1%, độ đặc hiệu 91,6%. Kết luận: Lactat máu ban đầu, 6 giờ, 24 giờ sau vào viện có tương quan đồng biến chặt chẽ với điểm ISS và điểm SOFA. Lactat máu ban đầu có hiệu lực tiên lượng tử vong tốt.The study aimed to evaluate the variation of lactate and the relationship of lactate with clinical, and laboratory characteristics as well as in treatment prognosis in severe trauma patients. Methods: The method of the study was a prospective, descriptive study performed on 187 severe trauma patients treated at Viet Duc Hospital from January 2020 to October 2020. Patients were taken arterial blood samples for lactate test and some clinical and laboratory parameters at 4-time points: T0, T1, T2, T3 respectively: Initial admission, 6 h, 24 h, and 48 h after admission. Results: Lactate reached the highest at initial admission and decreased over time
lactate at admission, 6 h, 24 h after admission was strongly correlated with ISS score with r0 = 0,702, r1 = 0,648, r2 = 0,513
lactate at all time points was strongly correlated with SOFA score with r0 = 0,776, r1 = 0,714, r2 = 0,627, r3 = 0,604
initial lactate had prognostic mortality value with AUC = 0,896, the cut-off value for prediction death of lactate was 5,9 mmol/l with a sensitivity of 78,1%, a specificity of 91,6%. Conclusion: Lactate at admission, 6 h, and 24 h after admission was strongly correlated with the ISS score and SOFA score. Initial lactate had good predictive value for mortality.

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