PAF、D-二聚体联合凝血功能指标检测在重症创伤伴TIC患者病情评估中的临床意义

Clinical significance of PAF,D-dimer combined with coagulation function in the evaluation of patients with severe trauma and trauma-induced coagulopathy( TIC)

目的探讨血小板活化因子(PAF)、D-二聚体联合凝血功能指标检测在重症创伤伴创伤性凝血功能异常(TIC)患者病情评估中的临床作用。方法回顾分析医院收治的27例符合重症创伤伴TIC诊断标准的患者及24例重症创伤不伴有TIC的患者的临床资料,对2组患者的PAF、D-二聚体、凝血功能指标、伤后1周存活率、伤后6个月生活质量优良率进行比较研究。结果治疗前30 min,TIC组PAF、D-二聚体、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)测定值高于非TIC组(P<0.01);治疗后24 h,2组PAF、D-二聚体测定值差异不显著(P>0.05),TIC组PT、APTT、TT测定值高于非TIC组(P<0.01);TIC组伤后1周存活率低于非TIC组(P<0.05),2组伤后6个月生活质量优良率差异不显著(P>0.05)。结论 PAF、D-二聚体联合凝血功能指标能够全面反映重症创伤伴TIC患者的病情,对预后评价及疾病治疗均有重要的参考价值。

Objective To investigate the clinical effect of PAF, D-dimer and coagulation function in the evaluation of the condition of patients with severe trauma and trauma-induced coagulopathy （TIC）. Methods Retrospective analysis was performed on the clinical data of 27 patients admitted to the hospital who met the criteria for severe trauma with TIC and 24 pa- tients who met the criteria for severe trauma without TIC. The PAF, D-dimer, coagulation index, survival rate at 1 week after injury, and good quality of life at 6 months after injury were compared in two groups. Results 30 min before treatment, the values of PAF, D-dimer, activated partial prothrombin time （APTY）, prothrombin time （PT）, and thrombin time （TY） in TIC group were higher than those in non-TIC group （P 〈0.01 ）. At 24 h after treatment, there was no significant difference in PAF and D-dimer between the two groups （P 〉 0.05）. The PT, APTT, and TY levels in the TIC group were higher than those in the non-TIC group （P 〈 0.01 ） ; The 1-week survival rate was lower in the group than in the non-TIC group （P 〈 0.05 ）. There was no significant difference in the quality of life rate between the 2 groups 6 months after injury （ P 〉 0.05 ）. Conclu- sion PAF, D-dimer combined coagulation function index can comprehensively reflect the condition of patients with severe trauma with TIC, which can be an important reference for the prognosis evaluation and disease treatment.