关键词: 严重脓毒症, 脓毒性休克, 乳酸清除率, 液体复苏

Abstract: 【Abstract】 Objective To explore the correlation between early lactate clearance and prognosis in patients with severe sepsis or septic shock, and evaluate the directive value of early lactate clearance for fluid resuscitation. Methods The clinical data of patients with severe sepsis or septic shock in emergency department from July 2009 to July 2012 were analyzed retrospectively..Sixty-eight patients were divided into survival group and non-survival group according to prognosis,.or low lactate clearance group and high lactate clearance group according to the level of lactate clearance after 6 hours..The mortality,.the level of baseline lactate and early lactate clearance were compared respectively. Results There was no statistical difference between the two groups in age,sex and the baseline of lactate (P>0.05). The early lactate clearance in survival group was significantly higher than that in non-survival group (31.04±12.65 vs 14.58±9.11,.P<0.01)..The mortality in high lactate clearance group was significantly lower than that in low lactate group(18.92% vs 61.29%,P<0.01). Conclusion Early lactate clearance is a good prognostic factor of severe sepsis and septic shock, and may serve as a guiding goal for early fluid resuscitation.

Key words: Severe sepsis, Septic shock, Lactate clearance, Fluid resuscitation