摘要
目的观察创伤患者的现场和到达急诊科时的凝血指标,评估凝血状态。方法收集69例创伤患者在现场和到达急诊时的凝血状态。观察指标包括凝血酶原时间国标比率、部分凝血酶时间、纤维蛋白原、D2聚体、血红蛋白、红细胞比积、血小板计数、晶体液、胶体液和血液制品。结果纤维蛋白原在现场和急诊科均有不同程度的消耗,但在现场和急诊科之间的比较没有明显差异(P=0.068);比较在现场与在急诊科时观察的数据,D2聚体大于4.0 mg/L的异常患者变化例数达到33%(P=0.035),在到达急诊科时升高显著,与在现场比较差异存在统计学意义(P=0.010)。结论创伤早期出现纤维蛋白原的激活和消耗,纤维蛋白代谢产物D2聚体升高,提示纤容亢进的存在,有早期应用抑制纤容药物的必要,为临床创伤救治和防治创伤性凝血病提供参考。
Objective To observe the coagulation indexes of trauma patients at the scene and at the emergency department.Methods Coagulation status of 69 trauma patients when they were on-scene and arrived at the emergency department were investigated.The international normalized prothrombin time ratio,activated partial thrombin time,fibrinogen,D2 polymers,hemoglobin,hematocrit,platelet,crystal solution,colloid solution and blood products were observed.Results Fibrinogen was consumed to varying degrees both in the field and at the emergency department,but there was no significant difference between the field and the emergency department(P=0.068).Indexes between on-scene and at the emergency department were compared,the number of abnormal patients with D2 aggregates greater than 4.0 mg/L was 33%(P=0.035).D2 polymers increased significantly when they arrived at the emergency department,which was significantly different from that on-scene(P=0.010).Conclusion Fibrinogen activation and consumption may occur early in injuries,and fibrin metabolites D2 polymers increase,it indicates that the presence of hyperfibrinosity is necessary for the early application of antifibrinosity drugs,which provides a reference for clinical injury treatment and prevention and treatment of traumatic coagulopathy.
作者
陈汀劳
骆慧莎
赵珍喜
徐美玲
庄君灿
CHEN Ting-lao;LUO Hui-sha;ZHAO Zhen-xi;XU Mei-ling;ZHUANG Jun-can(People’s Hospital of Jiangmen,Guangdong,Jiangmen,529000,China)
出处
《新疆医学》
2021年第10期1160-1164,共5页
Xinjiang Medical Journal
关键词
院前
创伤
凝血功能
创伤性凝血病
prehospital
trauma
coagulation function
traumatic coagulation
