本文選題：燒傷　切入點(diǎn)：預(yù)后　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討燒傷患者傷后第3天外周血中中性粒細(xì)胞絕對(duì)數(shù)與血小板計(jì)數(shù)的比值(NPR)在預(yù)后判斷中的作用。方法回顧性分析2008年1月至2015年12月,安徽醫(yī)科大學(xué)第一附屬醫(yī)院和上海瑞金醫(yī)院燒傷科收治的重度及以上成人燒傷患者610例,收集患者傷后第3天中性粒細(xì)胞和血小板計(jì)數(shù)的化驗(yàn)結(jié)果。依患者傷后第3天NPR中位數(shù)值,分高NPR(≥0.099)和低NPR(0.099)兩組,同時(shí)綜合考慮兩組患者性別、年齡、吸入性損傷、機(jī)械通氣、早期手術(shù)、燒傷指數(shù)等資料信息。對(duì)觀察指標(biāo)值行x2檢驗(yàn),利用Kaplan-Meier法分析嚴(yán)重?zé)齻颊咦≡浩陂g生存率,帶入Cox回歸分析并繪制88例死亡患者ROC受試者工作曲線,分析傷后第3天NPR對(duì)判斷嚴(yán)重?zé)齻颊哳A(yù)后的作用。結(jié)果傷后第3天高NPR組和低NPR組在嚴(yán)重?zé)齻≡浩陂g生存率分別為73.5%和91.5%,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。Cox回歸分析提示傷后第3天NPR(HR:0.572;95%CI:0.360-0.909)為預(yù)測(cè)燒傷后患者死亡的獨(dú)立危險(xiǎn)因素(P0.01)。88例死亡患者ROC曲線顯示,燒傷后第3天NPR值曲線下總面積為0.707(95%置信區(qū)間為0.650~0.764,P0.01)。其中傷后第3天NPR的最佳閾值為0.099(敏感性60.2%,特異性72.4%)。結(jié)論燒傷后第3天NPR對(duì)預(yù)測(cè)嚴(yán)重?zé)齻颊叩念A(yù)后有較強(qiáng)的臨床意義。
[Abstract]:Objective to investigate the role of the ratio of absolute neutrophil to platelet count in peripheral blood of burn patients on the third day after burn injury and to evaluate the prognostic value of NPR.Methods from January 2008 to December 2015, the relationship between NPRs and neutrophil count was analyzed retrospectively. 610 patients with severe burns and above were treated in the first affiliated Hospital of Anhui Medical University and the Department of Burn and Trauma of Ruijin Hospital in Shanghai. According to the median value of NPR on the 3rd day after injury, the patients were divided into two groups: high NPRR (鈮，

本文編號(hào)：1666250