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危重症患者血乳酸生成增加和/或清除减少致血乳酸水平明显升高,血乳酸水平是反映危重患者组织氧供需平衡的重要指标,也是休克严重程度的一个指标,与多脏器功能衰竭密切相关.乳酸清除率常常作为急危重症患者复苏充分性的一个指标,连续监测乳酸可以评价治疗反应,及时启动早期目标定向治疗可以临床获益.但是关于乳酸浓度能否指导医生诊断休克并采取复苏策略,目前仍存在争议.现对乳酸产生的病理生理过程和3种关于乳酸的复苏治疗能否改善预后的观点进行综述.“,”Serum lactate elevates significantly in critically ill patients may represent a state of overproduction and /or impaired clearance .Lactate is an important index of a mismatch between tissue oxygen supply and demand in the critically ill patient and also shows the severity of shock , and is associated with multiple organ failure closely .Lactate clearance is often as an indicator of the critical patient recovery sufficiency , the response of the treatment can be evaluated by lactate continuously monitored .Clinical benefits can be achieved by early goal directed therapy .But whether concentration of lactate can guide the diagnosis of shock or take recovery strategy is still controversial .This article analyzes the pathophysiological process of lactic acid and 3 kinds of views about whether the recovery of lactic acid can improve the prognosis .