摘要
目的 :探讨多发伤后早期外周血小板计数的变化规律及其临床意义。方法 :选择伤后 4 8h内的 90例多发伤者 ,连续观察入院后即刻、2 4、72、12 0和 16 8h的生命体征各指标及血小板、白细胞等变化 ,记录伤后器官功能变化、并发症及创伤严重等级评分 (ISS)和急性生理学与慢性健康状况 (APACHE )等评分。结果 :伤后患者血小板计数总体呈下降趋势 ,72 h为低谷 ,12 0 h基本恢复正常。血小板降低组较血小板正常组伤情重〔 ISS评分为 (2 9.6 0± 9.80 )分比 (2 2 .30± 12 .0 0 )分 ,P<0 .0 5 ;APACHE 评分为 (4 4 .5 0± 15 .30 )分比(30 .6 0± 10 .6 0 )分 ,P<0 .0 5〕、器官功能不全发生率高 (83.9%比 6 2 .7% ,P<0 .0 5 ) ;血小板降低并死亡组血小板下降时间早〔(30 .1± 10 .3) h比 (5 1.3± 14 .8) h,P <0 .0 5〕,持续低值时间长〔(6 3.7± 11.0 ) h比 (5 4 .2±13.4 ) h,P<0 .0 5〕。结论 :多发伤后血小板呈消耗性降低 ,血小板快速下降和持续低值者提示预后不佳。
Objective: To study the dynamic changes of platelet number in early multiple injured patients and its clinical significance.Methods: Ninety patients with multiple injury less than 48 hours were selected.Blood analysis was dynamicly investigated at 1, 24, 72, 120 and 168 hours after in hospital, and acute physiology and chronic health evaluationⅢ(APACHEⅢ) and injury seriousness scale (ISS) scores were recorded. Results: The platelet number declined after injury,reached the lowest point at 72 hours after in hospital, then restored to the normal level at 120 hours. In the platelet decrease group, the trauma was more critically 〔ISS(29.60±9.80) scores vs. (22.30±12.00) scores, P<0.05〕 and the incidence of multiple organs dysfunction syndrome (MODS) was higher than normal group (83.9 % vs. 62.7%, P<0.05).In the death group,the number of platelet was declined〔(30.1±10.3)hours vs. (51.3±14.8)hours, P<0.05〕 and the lasting tine was longer 〔(63.7±11.0) hours vs. (54.2±13.4)hours, P<0.05〕. Conclusion: The platelet number declines after multiple injury.The decrease and continuously lower level of platelet suggest poor prognosis.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第10期615-617,共3页
Chinese Critical Care Medicine
基金
成都军区科研基金资助项目 ( 99A0 0 4)
