合并急性肾损伤挤压综合征者部分血液及凝血指标的改变

The changes of partial blood and coagulation indexes in CS patient with acute kidney injure

目的探讨挤压综合征（CS）对急性。肾损伤（AKI）患者血红蛋白（Hb）、血小板（PLT）及凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）的影响。方法收集95例CS患者的临床资料，分为CS透析组和CS非透析组，按Hb、PLT降低程度分为4级，比较两组Hb及PLT、PT、APTT的改变以及两组血液制品输注情况。结果CS患者85例（89．5％）发生贫血，47例PLT降低（49．5％），合并AKI的CS透析组Hb和PLT降低程度更明显（P〈0．05）。CS透析组PT、APTT均较非透析组延长，但无统计学差异（P〉0．05）；CS透析组输血人次、输血量、输入血浆量均较非透析组高（P〈0．05）。结论CS患者可发生明显的血液及凝血功能的异常，造成Hb及PLT不同程度地降低，PT、APTT时间延长，在合并AKI的CS透析患者中，Hb及PLT降低程度更重，输血及血浆治疗在CS透析患者的救治过程中占据重要的地位。

Objective To investigate the effect of crush syndrome（CS） on haemoglobin（Hb） platlet（PLT） and partial coagulation indexes in patients with acute kidney injure（AKI）. Methods 95 patients diagnosed with CS were included. The patients were divided into dialysis group and non-dialysis group,and then re-divided into four degree from mild to severe by Hb and PLT. The changes of Hb, PLT, PT and APTT between the two groups, and the blood products input conditions of two groups were compared in later analysis. Results 85 patients （89. 5%） suffering anemia and 47 patients （49. 5%） with PLT decline. The reduction of Hb and PLT level in the dialysis group were even more dramatic than that of non-dialysis group（P〈0. 05）. The PT, APTT in dialysis group extended longer than that of non-dialysis group,although the change is not significant （P〉0. 05）. The patient＇s blood transfusion person-times and the volume of transfusion in dialysis group were much larger than that in non-dialysis group （P〈0. 05）. Conclusions CS can lead to impairment of blood and coagulative function, resulting in Hb and PLT reduction, accompanyed with PT and APTT extention. Dialysis patients of CS with AKI had lower degree of Hb,PLT than those of non-dialysis. The management with blood and plasma transfusion occupy an important position in rescuing CS patients.