【摘要】：目的：回顧性分析多器官功能障礙綜合征患者中凝血功能的變化，分析凝血功能障礙與APACHEII評分的關系，探討凝血功能相關指標對評估多器官功能障礙綜合征患者病情嚴重度的價值。方法：選取符合多器官功能障礙綜合征診斷標準的45例患者，入院后24h內(nèi)記錄相關所需資料，計算GCS評分和APACHEII評分。根據(jù)APACHEII評分的分值分3組：評分10-20分為A組，評分20-30分為B組，評分大于30分為C組。根據(jù)患者的預后分為生存組和死亡組。根據(jù)凝血功能相關指標將患者分為凝血功能指標正常組和異常組。結(jié)果：1.凝血功能指標異常組與正常組比較：APACHEII評分高于后者；病死率大于后者。2.生存組與死亡組比較：死亡組的PT、APTT延長，血小板計數(shù)降低；死亡組的APACHEII評分高于生存組；死亡組的年齡大于生存組。3.不同APACHEII評分組間凝血功能指標的比較:C組的PT值、APTT值最高，B組次之，，A組最低，差別有統(tǒng)計學意義;A組的血小板計數(shù)最高，B組次之，C組最低，差別有統(tǒng)計學意義。結(jié)論：合并凝血功能指標異常的多器官功能障礙綜合征患者病死率較高。老年患者易合并凝血功能指標異常且病情較重、病死率較高。凝血功能相關指標中PT、APTT及血小板計數(shù)與APACHEII評分有密切關系，隨著APACHEII評分的升高PT、 APTT延長，血小板計數(shù)下降。PT、APTT及血小板計數(shù)的檢測對判斷多器官功能障礙綜合患者預后及評估病情嚴重程度有一定價值。
[Abstract]:Objective: to retrospectively analyze the changes of coagulation function in patients with multiple organ dysfunction syndrome, and analyze the relationship between coagulation dysfunction and APACHEII score. To investigate the value of coagulation function related indexes in evaluating the severity of multiple organ dysfunction syndrome. Methods: 45 patients with multiple organ dysfunction syndrome were selected and the relevant data were recorded within 24 hours after admission. The GCS and APACHEII scores were calculated. According to the score of APACHEII score, it was divided into three groups: score 10-20 divided into group A, score 20-30 divided into group B, score more than 30 divided into group C. According to the prognosis, the patients were divided into survival group and death group. The patients were divided into normal group and abnormal group according to the indexes of coagulation function. Results: 1. Compared with the normal group, the APACHEII score was higher and the fatality rate was higher in the abnormal coagulation function group than that in the normal group. Survival group compared with death group: PT,APTT prolonged, platelet count decreased; APACHEII score of death group was higher than that of survival group; age of death group was larger than survival group. Comparison of coagulation function indexes among different APACHEII score groups: group C had the highest PT value, APTT value was the highest, group B was the second, group A was the lowest, the difference was statistically significant, the platelet count in group A was the highest, group B was the second, and group C was the lowest, the difference was statistically significant. Conclusion: the mortality of patients with multiple organ dysfunction syndrome with abnormal coagulation index is higher. The elderly patients are easy to be complicated with abnormal coagulation function index, and the disease is more serious, and the fatality rate is higher. PT,APTT and platelet count were closely related to APACHEII score in coagulation function related indexes. With the increase of APACHEII score, the platelet count decreased with the prolongation of PT, APTT. The detection of APTT and platelet count has certain value in judging the prognosis of patients with multiple organ dysfunction and evaluating the severity of the disease.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7

【參考文獻】

相關期刊論文 前4條

1 鄧小明,范曉華;連續(xù)性腎臟替代治療在非腎臟疾病中應用[J];國外醫(yī)學.麻醉學與復蘇分冊;2005年01期

2 賀航詠;楊媛華;;凝血4項的臨床應用[J];中國醫(yī)刊;2008年01期

3 江學成;危重疾病嚴重程度評分臨床應用和意義[J];中國危重病急救醫(yī)學;2000年04期

4 明自強;俞林明;呂銀祥;王黎衛(wèi);呂少敏;;血必凈注射液對膿毒癥患者凝血功能的影響[J];中國中醫(yī)急癥;2007年01期

本文編號：2309408