一氧化碳中毒后患者凝血指标水平变化及预后效果的临床评估

Clinical evaluation of coagulation index level and prognosis of patients after carbon monoxide poisoning

目的分析一氧化碳中毒(ACOP)后病人凝血指标水平变化及预后效果的临床评估。方法通过回顾性分析的方式,选取60例2018年1月—2020年1月在安阳市第六人民医院诊治的ACOP患者作为研究观察组,根据其疾病严重程度分为轻度组(n=24)、中度组(n=20)和重度组(n=16),另根据其预后情况分为不良预后组(n=26)和良好预后组(n=34);另选取同期体检的60例健康者作为对照组,对比分析两组患者的凝血功能指标水平[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]及临床相关指标(机械通气时间、ICU住院时间及碳氧血红蛋白含量)。结果观察组患者的PT、APTT水平低于对照组,FIB、TT水平高于对照组(P<0.05);与中度组、重度组比较,轻度组患者的PT、APTT水平较低,FIB、TT水平较高;良好预后组的PT、APTT水平低于不良预后组,FIB、TT水平高于不良预后组;与中度组、重度组比较,轻度组患者的机械通气时间、ICU住院时间较短,碳氧血红蛋白水平较低,差异有统计学意义(P<0.05)。结论对ACOP患者的凝血指标水平进行检测,可根据其水平变化情况判断患者的病情严重程度和预后,以便临床医师根据患者疾病严重程度为其制定针对性治疗方案,促进患者康复,进而缩短其机械通气和住院时间。

Objective To analyze the changes of blood coagulation indexes and the clinical evaluation of prognosis in patients with carbon monoxide poisoning(ACOP).Methods By retrospective analysis,60 ACOP patients admitted to our hospital from January 2018 to January 2020 were selected as the observation group.According to the severity of their disease,they were divided into mild group(n=24),moderate group(n=20)and severe group(n=16).According to their prognosis,they were divided into poor prognosis group(n=26)and good prognosis group(n=34).In addition,60 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.The levels of coagulation function indicators[prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),thrombin time(TT)]and clinical related indicators(mechanical ventilation time,ICU stay and carbon-oxy hemoglobin content)in 2 groups were compared and analyzed.Results Compared with the control group,PT and APTT levels in observation group were lower,FIB and TT levels were higher.Compared with moderate group and severe group,PT and APTT levels in mild group were lower,while FIB and TT levels were higher.Compared with the poor prognosis group,the levels of PT and APTT in the good prognosis group were lower,and the levels of FIB and TT were higher.Compared with the moderate group and the severe group,the mechanical ventilation duration,ICU hospitalization duration and carbohemoglobin level of the mild group were shorter,and the differences were statistically significant(P<0.05).Conclusion The level of coagulation indexes in ACOP patients can be detected,and the severity and prognosis of the patients can be judged according to the changes in the level,so that clinicians can formulate targeted treatment plans according to the severity of the patients’disease,promote the rehabilitation of the patients,and then shorten the mechanical ventilation and hospitalization time.