86例特重烧伤患者血小板计数变化和深静脉血栓的预防

The change of platelet count and prevention of deep vein thrombosis in 86 severely burnt patients

目的回顾86例特重烧伤患者伤后血小板计数(PLT)的变化,探讨深静脉血栓的预防办法。方法选50例健康志愿者作为对照组,取入院时伤后4、7、14、21、28 d的PLT值与对照组进行比较。结果入院时比对照组PLT稍有升高(P<0.05),伤后4 d明显小于对照组(P<0.01),伤后7 d恢复至正常范围,伤后14 d达到高峰,伤后14 d、21 d均明显大于对照组(P<0.01),28 d有下降,但乃高于对照组(P<0.01)。结论特重烧伤后患者PLT经短暂时间下降后增高,持续时间较长,其潜在的危害性是深静脉血栓形成;深静脉血栓预防包括尽量避免长时间深静脉置管,鼓励卧床患者早期肢体活动和锻炼,预防性用药可干扰血小板的活性和凝血因子的产生。

Objective To review the platelet count change （PLT） of 86 severely burning patient cases, a discussion had been conducted in terms of how to prevent deep vein thrombosis. Methods Fifty healthy volunteers were used as contrasting team, and then the PLT figure of inpatients after 4,7,14,21 and 28 days of their burning were compared with that of the contrasting team. Results There was a slight increase than that of the contrasting team concerning PLT （P 〈 0.05） at the time of being hospitalized. 4 days after the burning, the PLT was obviously lower than that of the contrasting team （P 〈 0.01 ）. 7 days after the burning, the PLT had recovered to normal scope. 14 days after the burning, the PLT had reached its peak. 14 and 21 days after the burning, both of the PLT were apparently higher than that of the contrasting team （P 〈 0.01 ）. There was a slight decline after 28 days but it was still higher than that of the contrasting team （P 〈 0.01 ）. Conclusion The PLT of severely burnt patients will increase after a short period of time decrease which would last for a longer time. The potential danger was the formation of deep vein thrombosis. The prevention of deep vein thrombosis includes avoiding deep vein puncture for a long time and encouraging patients who stayed in bed for a long time to have physical exercise and activities. The prophylaxis will disturb the activeness of platelet as well as the generating of blood coagulation factor.