急诊感染患者凝血障碍和患者脓毒症的关系及其参考价值

Correlation between Coagulation Disorders and Metastasizing Septicemia in Emergency Infected Patients and Reference Value

目的分析讨论急诊感染患者凝血障碍和患者脓毒症之间的关系,能够为临床上更好诊断病情,及时采取防治手段提供理论上依据。方法整群选择该院2012年7月—2014年9月救治的84例急性感染病人,依据病人全身炎症反应综合征(SIRS)和序贯器官衰竭(SOFA)的评分,将选择的病人划成单纯感染组、脓毒症组和重度脓毒症组3个组别,其中每个组别的病例数分别是30、33、21,病人入院24 h内,检查常规凝血功能。观察其D-二聚体、血小板计数、凝血酶原时间等的变化。结果重症脓毒症组病人D-二聚体增加到(5289±1196)μg/L,血小板计数减到(132.75±69.47)×109/L,和单纯感染组和脓毒症组对比,差异有统计学意义(P<0.05);其他指标凝血酶原时间、凝血酶时间以及纤维蛋白原等,3个组别之间比较差异无统计学意义。结论急诊感染病人凝血功能障碍和其脓毒症的恶化程度有着紧密的联系,检查病人的凝血功能对判别他的脓毒症恶化程度有着一定参考价值。

Objective To analyze and discuss the correlation between coagulation disorders and metastasizing septicemia in emergency infected patients and provide the theoretical basis for the better diagnosis of patient＇s condition and take prevention and control means in time. Methods 84 cases of emergency infected patients treated in our hospital from July 2012 to September 2014 were selected and divided into the simple infection group（30 cases）, the sepsis group（33 cases） and the severe sepsis group（21 cases） according to the systemic inflammatory response syndrome（SIRS） and sequential organ failure assessment（SOFA） of the patients, the routine coagulation function was examined in 24 hours after admission, the changes of D-dimer, platelet count and prothrombin time were observed. Results The D-dimer increased to（5289±1196）μg/L, the platelet count decreased to（132.75±69.47）×109/L in the severe sepsis group, there were obvious differences compared with those in the simple infection group and the sepsis group with statistically significance P〈0.05, there was no obvious difference in the other indicators including prothrombin time, thrombin time and contractinogen between the three groups. Conclusion The coagulation disorders had a close correlation with the deteriorated severity of metastasizing septicemia in emergency infected patients, the examination of the patient＇s coagulation function has a certain reference value for distinguishing the deteriorated severity of metastasizing septicemia.