【摘要】：目的:對(duì)創(chuàng)傷患者受傷早期血漿鈣離子濃度進(jìn)行測(cè)定，探究不同受傷程度下患者鈣離子濃度的差異，為臨床創(chuàng)傷后低鈣血癥患者的治療提供依據(jù)。 方法: 1一般資料 本實(shí)驗(yàn)觀察自2012年1月至2013年3月收住我科的創(chuàng)傷患者。納入及排除標(biāo)準(zhǔn)：既往體健，無(wú)心肺疾病史，排除肝硬化，慢性腎功能衰竭，惡性腫瘤，甲狀旁腺功能異常，垂體受損,血紅蛋白小于7g/dl需輸血及超過(guò)24小時(shí)送入我科者。符合條件者共計(jì)82例，其中男56例，女26例；年齡范圍18歲至60歲；交通事故傷60例；墜落傷16例；其他如打架斗毆傷，擠壓傷等6例。存活76例，死亡6例。 2試驗(yàn)方法 對(duì)于符合試驗(yàn)標(biāo)準(zhǔn)的患者，按照檢測(cè)要求入院后即刻抽取靜脈血三份送檢，通過(guò)COBOS B221血?dú)夥治鰞x測(cè)定鈣離子濃度，以三次鈣離子濃度的平均值作為統(tǒng)計(jì)數(shù)據(jù)。依據(jù)國(guó)際通用的創(chuàng)傷嚴(yán)重度評(píng)分（ISS）對(duì)患者進(jìn)行評(píng)分及分組。所有患者入院積極處理原發(fā)疾病，維持循環(huán)穩(wěn)定并予以相應(yīng)的對(duì)癥、支持治療。觀察各組患者預(yù)后情況，，統(tǒng)計(jì)各組病人的病死率。 3統(tǒng)計(jì)分析 運(yùn)用SPSS13.0統(tǒng)計(jì)分析軟件進(jìn)行統(tǒng)計(jì)學(xué)描述及分析，計(jì)量數(shù)據(jù)用均數(shù)±標(biāo)準(zhǔn)差表示，ISS評(píng)分各組間鈣離子水平差異比較采用方差分析，兩組間比較采用t檢驗(yàn)，病死率組間比較用卡方檢驗(yàn)。 結(jié)果： 符合條件者共計(jì)82例，其中男56例，女26例；年齡范圍18歲至60歲；交通事故傷60例；墜落傷16例；其他如打架斗毆傷，擠壓傷等6例。存活76例，死亡6例。根據(jù)ISS評(píng)分進(jìn)行分組：A組（ISS16分）25例,B組（16分≤ISS25分）27例，C組（ISS≥25分）30例。創(chuàng)傷患者早期鈣離子濃度水平與正常生理狀態(tài)下比較明顯降低，創(chuàng)傷程度越重的患者其鈣離子濃度越低。存活組與病死組之間鈣離子濃度及ISS評(píng)分存在顯著差異。 結(jié)論: 1創(chuàng)傷患者早期存在電解質(zhì)紊亂，表現(xiàn)為低鈣血癥，離子鈣濃度降低的水平與創(chuàng)傷嚴(yán)重程度及預(yù)后有一定關(guān)系。 2離子鈣水平在臨床可以作為一項(xiàng)重要指標(biāo)或者結(jié)合其他指標(biāo)對(duì)創(chuàng)傷患者進(jìn)行早期評(píng)估及指導(dǎo)臨床治療。
[Abstract]:Objective: to investigate the difference of plasma calcium concentration in patients with trauma at the early stage of trauma, and to provide evidence for the treatment of patients with hypocalcemia after trauma. Methods: 1 General data from January 2012 to March 2013 were observed. Inclusion and exclusion criteria: past physical fitness, no history of heart disease, exclusion of cirrhosis, chronic renal failure, malignant tumor, abnormal parathyroid function, impaired pituitary gland, hemoglobin less than 7g/dl need blood transfusion and more than 24 hours to be sent to our department. A total of 82 cases were eligible, including 56 males and 26 females, aged from 18 to 60 years old, 60 cases of traffic accident injury, 16 cases of falling injury, 6 cases of other cases such as fight and fight injury, crush injury and so on. There were 76 cases of survival and 6 cases of death. 2 for the patients who met the test standard, three samples of venous blood were collected immediately after admission according to the test requirements. The calcium ion concentration was measured by COBOS B221 blood gas analyzer, and the average value of the three times calcium ion concentration was taken as the statistical data. Patients were graded and grouped according to the international trauma severity scale (ISS). All patients were admitted to hospital to actively deal with primary diseases, maintain stable circulation and corresponding symptomatic, supportive treatment. The prognosis and mortality of each group were observed. 3The statistical analysis was described and analyzed by SPSS13.0 software. The measurement data were expressed as mean 鹵standard deviation. The difference of calcium level in ISS score was compared with variance analysis, and t test was used in the comparison between the two groups. The mortality rate was compared by chi-square test. Results: a total of 82 cases were qualified, including 56 males and 26 females, aged from 18 to 60 years old, 60 cases of traffic accident injury, 16 cases of falling injury, 6 cases of other cases such as fight injury, crush injury and so on. There were 76 cases of survival and 6 cases of death. According to ISS score, there were 25 cases in group A (ISS16), 27 cases in group B (16 鈮

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