摘要
目的分析急性重症创伤患者凝血功能障碍与病情严重程度及预后的关系，为·临床早期诊断、治疗及预后评估提供参考。方法选择2015年4月至2016年3月收治的针对性重症创伤患者68例为观察对象，根据损伤严重评分（ISS）分为非危重组、危重组、极危重组，根据预后情况分为存活组、死亡组。入院24h内，检测及评估凝血酶原时间（PT）、部分活化凝血酶原时间（APTT）、纤维蛋白原浓度（FIB）、D-二聚体（D-D）、血小板计数（PLT）急性生理学指标以及与慢性健康状况评分系统（APACHEⅡ）。结果极危重组PT、APTT、D-D、指标明显高于非危重组、危重组，FIB、PLT明显低于非危重组、危重组，危重组PT、APTT、D-D明显高于非危重组，FIB、PLT明显非危重组（P〈0．05）．死亡组患者PT、APTT、D-D明显高于存活组，FIB、PLT明显低于存活组（P〈0．05）．APACHEII评分与PT、APTT、D-D呈正相关性（r=0．321，0．654，0．472，0．412，P〈0．05），与FIB、PLT呈负相关性（r=-0．324，0．412，P〈0．05）。结论急性重症创伤患者血清PT、APTT、FIB、D-D、PLT等凝血功能指标与APACHEII评分有良好的相关性，一定程度能够反映出急性重症创伤患者的疾病严重程度，也可作为评估患者预后的有效指标。
Objective To analyze blood coagulation dysfunction in patients with acute severe trauma and disease severity and prognosis of relationship, for clinical early diagnosis, treaunent and prognosis assessment. Methods 68 cases with severe trauma in our hospital from April 2015 to March 2016 were selected as the research objects.According to the severity score of injury （ISS）, they were divided into non critical recombination, critical recombination and critical recombination. According to their prognosis, they were divided into survival group and death group. In 24h of admission, detection and evaluation of prothrombin time （ PT ） , activated partial thromboplastin time （ APTT ） , fibrinogen （ FIB ） , two D- dimer （ D-D ） , platelet count （ PLT ） and acute physiology and chronic health evaluation （ APACHE II ） were tested and evaluated. Results Critically, APTT, D-D, recombinant PT index were significantly higher than that of non hazardous and hazardous restructuring restructuring, FIB and PLT were significantly lower than those of non hazardous and dangerous recombination recombination, recombinant PT, APTT, D-D risk were significantly higher than that of non hazardous restructuring, FIB, PLT were non critical group （ P〈0.05 ） .Death group of patients with PT, APTT, D-D were higher than the survival group, FIB and PLT were significantly lower than the survival group （ P〈0.05 ） .the APACHE score and PT, APTT and D-D were positively correlated （ r=0.321, 0.654, 0.472, 0.412, P〈0.05 ） , and negatively correlated with FIB, PLT （ r=-0.324, 0.412, P〈0.05 ） .Conclusion Acute severe trauma patients with serum PT, APTT, FIB, D-D, PLT, coagulation function index and APACHE score have good correlation, to a certain extent can reflect the acute severe trauma patients with the severity of the disease, also be used as an effective indicator to evaluate the prognosis of patients.
出处
《浙江临床医学》
2018年第4期672-673,共2页
Zhejiang Clinical Medical Journal
