多发伤患者急性创伤性凝血病相关因素分析

Related Factors of Acute Traumatic Coagulopathy in Patients with Polytrauma

目的探讨多发伤患者急性创伤性凝血病(ATC)的相关因素。方法回顾分析近2年我院收治的113例多发伤患者的临床资料。根据是否存在休克、低体温、酸中毒分组。入院当日取外周静脉血检测凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)等指标,进行损伤严重度(ISS)评分测定。结果多发伤患者PT>18 s、APTT>60 s、TT>15 s与ISS评分呈正相关。休克组较非休克组、低体温组较非低体温组、酸中毒组较非酸中毒组PT>18 s、APTT>60 s、TT>15 s患者均明显增多,差异有统计学意义(P<0.05)。结论多发伤患者凝血异常与损伤程度、病理生理状况存在一定相关性,监测多发伤患者凝血指标,对于判断患者病情、成功诊治多发伤患者具有重要指导意义。

Objective To explore the related factors of acute traumatic coagulopathy among polytrauma patients.Methods Clinical data of 113 polytrauma patients admitted to our hospital over the past two years were analyzed retrospectively.The patients were divided into 3 groups：shock,hypothermia and acidosis according to their physiological status.Indices including prothrombin time（PT）,activated partial thromboplastin time（APTT）,and thrombin time（TT） were measured on the first day of admission.Injure severity sorces（ISS） were evaluated at the same time.Results PT（18 s）,APTT（60 s）,and TT（15 s） in polytrauma patients were positively correlated with ISS.Percentages of patients with PT18 s,APTT60 s,and TT15 s were significantly higher in the shock group,the hypothermia group,the acidosis group than in the non-shock group,the non-hypothermia group,and the non-acidosis group（P0.05）.Conclusion In polytrauma patients,disturbance of blood coagulation is correlated with the degree of injury and the physiological status.Monitor of blood coagulation indices is of great importance in reading the condition of the patients and achieving correct diagnosis.