多发伤严重程度与早期血清钙离子水平的临床研究

Study on injury severity of multiple trauma and level of early serum calcium ion

目的对多发伤患者早期血清钙离子(Ca^(2+))水平进行监测,观察不同程度损伤患者血清Ca^(2+)水平的差异,并探讨其临床意义。方法选取该院急诊重症监护室(EICU)2016年6~12月收治的多发伤患者72例,根据损伤严重程度评分(ISS)分为A组(ISS<16分)和B组(ISS≥16分),每组36例;选取同期健康志愿者10例作为对照组(C组)。检测三组研究对象血清Ca^(2+)、血红蛋白(Hb)、凝血酶原时间(PT)等并分析其相关性。结果A、B组患者血清Ca^(2+)、Hb均明显低于C组,PT明显高于C组,差异均有统计学意义(P<0.05);B组患者血清Ca^(2+)、Hb均明显低于A组,PT明显高于A组,差异均有统计学意义(P<0.05);A组患者ISS评分、病死率均明显低于B组,差异均有统计学意义(P<0.05)。ISS评分与血清Ca^(2+)水平呈负相关;血清Ca^(2+)水平与Hb呈正相关,与PT呈负相关;血清Ca^(2+)水平越低患者预后越差。结论多发伤患者早期存在低钙血症,与创伤程度及预后相关;多发伤患者血清Ca^(2+)水平可作为判断其严重程度及预后的指标。

Objective To monitor the early serum calcium ion concentration in patients with multiple trauma and to observe the variance of serum calcium ion concentration under different degree of damage and discuss its clinical significance. Methods Totally 72 patients with multiple trauma were collected from June 2016 to December 2016 in emergency intensive care unit（EICU）in our hospital,then were devivided into group A（ISS16 points） and group B（ISS≥16 points） according to the injury severity score（ISS）,36 cases in each group. Moreover, 10 normal cases were enrolled as control group（group C）.Detect the level of early serum calcium ion（Ca2 ＋）,hemoglobin（Hb）,prothrombin time（PT） in the three groups and analyse their correlation. Results The serum Ca2＋and Hb of the group A and B were lower than those of the group C and the PT was higher than that of group C,which has significantly statistical difference（P0.05）;the serum Ca2＋and Hb of the group A was lower and the PT was higher than those of group B, the difference was stastically significant（P0.05）;the ISS score and mortality of group A were signif icantly higher than those in group B（P0.05）.The ISS score was negatively related to the serum calcium ion concentration while the serum calcium ion concentration was positively related with Hb,and negatively correlated with PT; the lower the serum calcium ion concentration,the worse prognosis will. Conclusion Multiple trauma patients with early hypocalcemia is associated with traumatic degree and prognosis;the serum calcium ion level in multiple trauma patients can be used as judgement index for the severity and prognosis.