摘要
目的 研究危重（重度、特重度）烧伤患者凝血功能的改变,及其对病情严重度和预后的判断价值.方法 以我院烧伤科收治的113例危重烧伤患者作为研究对象,按有无并发全身炎症反应综合征（SIRS）分为SIRS组和非SIRS组;SIRS组分为生存组和死亡组;按各凝血指标值分为凝血指标正常组和异常组.测定血浆凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、纤维蛋白原（FIB）、D-二聚体（D-dimer）及血小板（PLT）,同时记录患者的急性生理和慢性健康状况评分Ⅲ（APACHEⅢ）.结果入院时SIRS组FIB、PLT显著高于非SIRS组（P〈0.05）,PT、APTT较非SIRS组显著缩短（P〈0.05）.死亡组D-dimer、PLT显著高于生存组（P〈0.05）,PT、APTT较生存组显著缩短（P〈0.05）.凝血指标异常组APACHEⅢ评分显著高于正常组（P〈0.05）.结论 危重烧伤患者凝血功能出现明显异常,其中PT、APTT、D-dimer、PLT对病情严重度及预后有重要的判断价值.
Objective To investigate the relationship between the severity, prognosis of the critically burned patients and the coagulation dysfunction. Methods 113 cases of critically burned patients were divided into 2 groups： systemic inflammatory response syndrome （SIRS）and non- SIRS according to the criteria of SIRS;survival group and death group according to the outcome;normal group and abnormal group according to coagulation markers. Platelets and four coagulation markers were measured and APACHE Ⅲ scores were determined at the admission day. The differences of coagulation markers between the two groups were analyzed and the relationship between the coagulation markers and APACHE Ⅲ scores were studied. Results The level of platelet was higher and the level of fibrinogen （FIB） were dramatically higher in SIRS group than those in non - SIRS group （ P 〈 0. 05 ）, while prothrombin time （ PT ） and activated partial thromboplastin time （ APTT ） were obviously shorter （ P 〈 0. 05 ）. The level of platelet was higher and the level of D - dimer was dramatically higher in death group than those in survival group（ P 〈 0.05 ）, while PT, APTT were obviously shorter（ P 〈 0.05 ）. APACHE Ⅲ scores of patients whose PT, APTT, FIB, D - dimer and platelet were abnormal were dramatically higher than those of patients with normal markers （P 〈 0.05 ）. Conclusion The coagulation dysfunction of critically burned patients is associated with the severity and prognosis of the illness.
出处
《中国急救医学》
CAS
CSCD
北大核心
2010年第7期592-595,共4页
Chinese Journal of Critical Care Medicine
