The Relationship Between Early Lactate Clearance Rate And BE And Prognosis In Patients With Traumatic Hemorrhagic Shock In Xining

Objective:To dynamically detect the early arterial blood lactic acid,lactate clearance rate and base excess in patients with traumatic hemorrhagic shock in Xining area,and to explore their relationship with the prognosis of patients with traumatic hemorrhagic shock.Methods:Collected patients with trauma and hemorrhagic shock in the ICU of the Affiliated Hospital of Qinghai University from December 2017 to December 2020 in Xining area,and were given conventional treatment measures after admission.The lactic acid,arterial blood lactic acid and base excess at 6h,12 h,24h after admission were dynamically detected,and the lactate clearance rate was calculated at 6h,12 h,24h after admission.Simultaneously monitor various laboratory indicators,and calculate the APACHEII score based onthe worst value of each indicator within 24 hours of admission.According to the outcome of 28 days after entering the hospital,they were divided into death group and survival group,,and the differences of the above indicators were compared.Then analyze the relationship between APACHEII score and the arterial blood lactic acid,lactate clearance rate and base excess at different time nodes,and conduct multivariate analysis through logistic stepwise regression.Calculation formula:Lactate clearance rate =(Lactic acid concentration before resuscitation-Lactic acid concentration after resuscitation)/ Lactic acid concentration before resuscitation × 100%.Results:1.103 cases of patients who met the diagnostic criteria for traumatic hemorrhagic shock were admitted and were(42.07±14.807)years old.Among them,46 were injured by car accident,21 were injured by falling from height,24 were injured by knife,and 12 were injured by others.2.Analyze the general conditions of the patients,and the difference in mean arterial pressure(MAP),APACHE Ⅱscore,and admission PH value between the two groups was statistically significant(P<0.05).3.Analyze the lactic acid value,lactate clearance rate,and base excess of the patients in the survival group and the death group at each time node,and analyze the differences between the two groups of patients are statistically different(P<0.05).4.Correlation analysis of lactic acid,lactate clearance rate,base excess and APACHEII score at different time nodes,arterial blood lactic acid is positively correlated with APACHEII,and lactate clearance rate and base excess at each time node are negatively correlated with APACHEII;5.Multi factors Logistic regression analysis showed that the admission lactate value,6h lactate clearance rate,and 24 h base excess were risk factors influencing the prognosis of sick persons with traumatic hemorrhagic shock.Conclusion:1.Early arterial blood lactic acid,lactate clearance rate and base excess value in high altitude areas of Xining can be used as prognostic indicators for evaluating traumatic hemorrhagic shock patients.2.Arterial blood lactic acid level in patients with traumatic hemorrhagic shock is positively correlated with APACHE score,while base excess and lactate clearance rate are negatively Ⅱcorrelated with APACHE Ⅱscore,and the overall correlation between lactic acid level and APACHE score is stronger.3.Admission lactic acid value,6h lactate Ⅱclearance rate,24 h base excess are risk factors influencing the prognosis of sick persons with traumatic hemorrhagic shock.