176例特重度烧伤合并血小板减少的临床分析

Clinical analysis of severe burn complicated with thrombocytopenia in 176 cases

目的:探讨特重度烧伤合并血小板减少的原因和临床特点。方法:回顾性分析2000年1月至2014年12月本院176例特重度烧伤合并血小板减少患者的临床资料。根据伤后血小板计数水平将患者分为A组(68例)、B组(56例)、C组(52例),比较各组患者烧伤面积、烧伤指数、异常出血发生率、脏器并发症发生率及病死率有无差异。结果:A组与B组烧伤面积无明显差异,B组与C组烧伤面积、A组与C组的烧伤面积经比较差异具有统计学意义(P<0.05),而烧伤指数各组两两比较差异均有统计学意义(P<0.05)。各组的异常出血并发症差异无统计学意义(P>0.05),而脏器并发症及死亡率差异有统计学意义(P<0.05)。结论:血小板减少程度与烧伤指数有关,能够反映烧伤病情的严重程度,对其预后有一定参考价值。

Objective： To explore the etiology and the clinical characteristics of severe burn complicated with thrombocytopenia. Methods： 176 cases of severe burn patients complicated with thromboeytopenia were retrospectively studied from January 2000 to December 2014. According to the level of platelet count after burn,the patients were divided into three groups： group A（ 68 cases）,group B（ 56 cases）,and group C（ 52 cases）. Burn area,burn index,mortality,the incidence of abnormal bleeding and visceral complication rate were compared among the groups. Results： There was no significant difference in burn area between group A and group B（ P〉0. 05）,there were significant differences between group B and group C,and between group B and group C（ P〈0. 05）. But burn index has significant difference between the groups（ P〈0. 05）. The incidence of abnormal bleeding had no statistical significance between the groups（ P〉0. 05）,while there were significant differences in visceral complications and mortality rate（ P〈0. 05）. Conclusion： Thrombocytopenia associates with burn index,it can reflect the severity of burn patient,which has a certain reference value for the prognosis.