本文選題：急診 + 感染�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年23期

【摘要】：目的探討急診感染患者凝血障礙與膿毒血癥之間的關(guān)系及其參考價(jià)值。方法選取2014年1月-2015年12月期間醫(yī)院收治的128例急性感染患者作為臨床研究對(duì)象,根據(jù)全身炎癥反應(yīng)綜合征評(píng)分及序貫器官衰竭評(píng)分將患者隨機(jī)分為單純感染組46例、膿毒血癥組50例、重度膿毒血癥組32例,并分別對(duì)三組急診感染患者的死亡情況、凝血指標(biāo)變化情況、抗凝指標(biāo)變化情況、炎癥指標(biāo)變化情況進(jìn)行比較和分析。結(jié)果與單純感染組病死率6.52%、膿毒血癥組病死率10.00%比較,重度膿毒血癥組的病死率上升為34.38%,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與單純感染組、膿毒血癥組比較,重度膿毒血癥組的血小板計(jì)數(shù)(PLT)和D-二聚體均升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與單純感染組、膿毒血癥組比較,重度膿毒血癥組的抗凝血酶Ⅲ抗體(AT-Ⅲ)、活化蛋白C(APC)均明顯降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);與單純感染組、膿毒血癥組比較,重度膿毒血癥組的C-反應(yīng)蛋白(CRP)、腫瘤壞死因子-α(TNF-α)均升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論急診感染患者凝血障礙與膿毒血癥嚴(yán)重程度密切相關(guān),對(duì)凝血功能的檢測(cè)必將為準(zhǔn)確判斷患者膿毒血癥病情的嚴(yán)重程度提供具有價(jià)值的參考。
[Abstract]:Objective to study the relationship between coagulation disorder and sepsis in emergency infection patients and its reference value.Methods 128 patients with acute infection from January 2014 to December 2015 were selected as clinical study objects. According to systemic inflammatory response syndrome score and sequential organ failure score, the patients were randomly divided into simple infection group (46 cases).There were 50 cases in sepsis group and 32 cases in severe sepsis group. The death rate, coagulation index, anticoagulant index and inflammatory index were compared and analyzed in three groups.Results the fatality rate of severe sepsis group was 34.38 compared with that of simple infection group (6.52%) and sepsis group (10.00%), the difference was statistically significant (P 0.05), and that of sepsis group was higher than that of simple infection group (P 0.05), and that of sepsis group was 10.00% (P < 0.05).In severe sepsis group, the platelet count (PLT) and D-dimer increased significantly (P 0.05), compared with those in infection group and sepsis group, the levels of AT- 鈪，

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