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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

21卷

期数:

2015年04期

页码:

317-320

栏目:

临床医学

出版日期:

2015-07-15

文章信息/Info

Title:

Lactate clearance rate predicting postoperative complications after radical esophagectomy for cancer

文章编号:

1006-8147（2015）04-0317-04

作者:

杜卓然¹; 张 鹏²; 刘毅梅²; 张 辉²; 陈 渊²; 崔元涛²; 董尚文² 

（1.天津医科大学研究生院，天津 300070；2.天津医科大学总医院心胸外科，天津 300052）

Author(s):

DU Zhuo-ran; ZHANG Peng; LIU Yi-mei; ZHANG Hui; CHEN Yuan; DONG Shang-wen

 （1. Graduate School, Tianjin Medical University，Tianjin 300070, China; 2.Department of Thoracic Surgery，General Hospital，Tianjin Medical University，Tianjin 300052，China）

关键词:

食管癌; 乳酸清除率; 早期并发症

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Keywords:

esophageal carcinoma;  lactate clearance;  early complication

分类号:

R735.1

DOI:

-

文献标志码:

A

摘要:

目的 ：研究不同时间动脉血乳酸清除率（LCR）对食管癌根治术术后并发症的预测价值。方法：回顾研究82例食管癌根治术后患者临床资料，根据有无并发症分为并发症组和无并发症组。比较两组术后6 h、24 h和48 h LCR、APACHEⅡ（急性生理学及慢性健康状况评分），判断术后并发症的危险因素,用多元Logistic分析独立危险因素， ROC曲线评价预测价值。结果：并发症组6 h[(12.9±5.6)%vs.(38.2±14.7)%,P＜0.001]、24 h[(33.8±17.7)%vs.(58.2±13.5)%,P＜0.001]、48 h[(55.7±18.8)%vs.(71.7±11.4)%,P＜0.001]乳酸清除率明显低于无并发症组，并发症组APACHEⅡ评分[（16.1±4.5）分 vs.（13.5±2.4）分,P＜0.001]明显高于无并发症组，差异具有统计学意义。多元Logistic回归分析示：6 h乳酸清除率是术后并发症的危险因素。6 h 、24 h 、48 h乳酸清除率ROC曲线下面积分别是0.984、0.848、0.774。结论：6 h乳酸清除率可作为预测食管癌根治术后并发症的可靠指标。

Abstract:

Objective: To assess the role of lactate clearance rate(LCR) over time in predicting early postoperative complications led by radical esophagectomy for cancer. Methods: Data of 82 patients undergoing open thoracic esophagectomy were prospectively analyzed. According to the condition of complications, patients were divided into two groups: complication group and non-complication group. Comparison of APACHEⅡ (Acute Physiology and Chronic Health Evaluation)，LCR at 6 h，24 h，48 h and other parameters between two groups and Logistic regression were applied to identify risk factors of postoperative complications and ROC curve to investigate its role. Results： With significant difference, 6 h[(12.9±5.6)% vs.(38.2±14.7)%,P＜0.001]，24 h[(33.8±17.7)%vs.(58.2±13.5)%,P＜0.001]，48 h[(55.7±18.8)%vs.(71.7±11.4)%,P＜0.001] LCR of complication group was lower than that of non-complication group while APACHEⅡ score[（16.1±4.5） vs.（13.5±2.4）,P＜0.001] was significantly different two the groups. Multivariate Logistic regression analysis showed 6 h lactate clearance was an independent risk factor for postoperative complications. Areas under the ROC curve of 6 h，24h and 48h LCR were 0.984，0.848 and 0.774. Conclusion: 6 h LCR can be regarded as a reliable predictor of postoperative complications after open thoracic radical esophagectomy for cancer.

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备注/Memo

备注/Memo:

作者简介 杜卓然（1989-），男，硕士在读，研究方向：胸心外科学；通信作者：张鹏，E-mail：zhangp.tgh@hotmail.com。

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更新日期/Last Update: 2015-07-16