本文關(guān)鍵詞：特重度燒傷患者凝血功能動態(tài)變化特點及與預后的關(guān)系，由筆耕文化傳播整理發(fā)布。

特重度燒傷患者凝血功能動態(tài)變化特點及與預后的關(guān)系

Characteristics of the dynamic changes of coagulation function in patients with severe burn and its relationship with prognosis

[1] [2] [3] [4] [5]

WANG Xiao- gang, ZHOU Bao- chun, ZHAO Xu- ruing, et al.（ Emergency and Intensive Medicine, the Second Hospital Affilated to Suzhou University, Suzhou 215004, China）

蘇州大學附屬第二醫(yī)院急診與重癥醫(yī)學科,江蘇 蘇州215004

文章摘要：目的：動態(tài)觀察特重度燒傷患者凝血功能的動態(tài)變化，探討特重度燒傷患者凝血功能障礙的特點及其與預后的關(guān)系。方法以回顧性觀察研究的方法，，對在同一時間段收入ICU的15例特重度燒傷患者作為研究對象。根據(jù)患者90 d存活與否分為存活組和死亡組，動態(tài)觀察28 d兩組患者一般臨床特征和凝血相關(guān)指標的變化特點。結(jié)果入ICU后第1、2天兩組患者的凝血酶原時間（ PT）和活化部分凝血活酶時間（ APTT）均明顯延長，并且死亡組較存活組更加明顯（P＜0．05）。在入院時兩組患者抗凝血酶Ⅲ（AT－Ⅲ）水平均明顯低于正常下限，存活組患者1周內(nèi)漸恢復至正常水平，而死亡組患者持續(xù)處于低水平狀態(tài)。入院時兩組患者的血小板計數(shù)均明顯升高，超過正常上限；此后急劇下降呈低下狀態(tài)，1周后逐漸恢復接近正常水平。結(jié)論特重度燒傷患者凝血功能早期出現(xiàn)明顯異常，表現(xiàn)低凝狀態(tài)伴有血小板減少。 AT－Ⅲ持續(xù)低下是嚴重燒傷患者預后不良的特征之一。

Abstr：Objective The aim of present study was to find out the characteristics of coagulation function , and to investigate the relationship between the coagulation dysfunction and the prognosis in the critically burned patients .Methods The retrospective observation study was employed .According to the outcome of 90-day-mortality, 15 severe burn patients were divided into 2 groups, survival and non-survival groups . The number of platelet and the parameters of coagulation function were dynamically observed during 28 days following heat injury . Results In the first two days after admission, the parameters of coagulation , prothrombin time （ PT） and activated partial thromboplastin time （ APTT） , were significantly prolonged in both groups , and also these two parameters in non -survival group were longer than those of survival group （P〈0.05）.The Antithrombin Ⅲ （AT-Ⅲ） were already in the deficiency state in both groups on admission .The level of AT -Ⅲ in the survival group recovered gradually during the first week , but in the non-survival group , the deficiency state of AT-Ⅲ was persistent till the end of observation period .Although the level of platelet number was dramatically elevated on admission , the state of thrombocytopenia in both groups was persistent for the subsequent week .Conclusion The coagulation dysfunction exists at early phase of severely burned patients, and mainly appears as the state of coaguplopathy , along with thrombocytopenia; and the sustained state of AT-Ⅲdeficiency is characterized by the poor outcome of severely burned patients .

文章關(guān)鍵詞：

Keyword：:Severe burn Coagulation dysfunction Dynamic change Prognosis

課題項目：江蘇省衛(wèi)生廳項目（H201466）;蘇州市衛(wèi)生局課題資助（Lczx201415）

  本文關(guān)鍵詞：特重度燒傷患者凝血功能動態(tài)變化特點及與預后的關(guān)系，由筆耕文化傳播整理發(fā)布。