严重多发伤并发急性创伤性凝血病的临床特征

Clinical features of severe multiple injuries complicated with acute traumatic coagulopathy

目的研究严重多发伤并发急性创伤性凝血病的临床特征及预后相关因素。方法回顾性分析我院2015年3月～2017年9月收治的178例严重多发伤的各项临床资料,通过研究数据资料对其疾病的临床特征进行分析。结果 (1)ATC组ISS评分、APACHEⅡ评分、休克指数、Lac指标均高于非ATC组,差异有统计学意义(P <0.05);ATC组HGB、HCT、PLT、碱剩余指标均低于非ATC组,差异有统计学意义(P <0.05);ATC组与非ATC组体温、PH指标无统计学意义(P> 0.05)。(2)ATC组使用悬浮红细胞、使用血浆、使用血小板、使用冷沉淀、ICU住院天数指标均高于非ATC组差异有统计学意义(P <0.05)。(3)ATC组死亡率28.2%高于非ATC组死亡率7.5%,差异有统计学意义(P <0.05)。结论并发ATC较非ATC患者临床预后更差,应注意早期识别并发ATC的危险因素,尽早着手处理以改善患者预后。

Objective To study the clinical features and prognostic factors of severe multiple injuries complicated with acute traumatic coagulopathy.Methods Clinical data of 178 patients with severe multiple injuries who were admitted and treated in our hospital from March 2015 to September 2017 were retrospectively analyzed. The clinical features of the disease were analyzed by studying the data. Results (1)The ISS score, APACHE II score, shock index and Lac index in ATC group were all higher than those in non-ATC group and the difference was significant (P < 0.05). The HGB,HCT,PLT, base excess index in ATC group were all lower than those in non-ATC group and the difference was significant (P < 0.05). There was no significant difference between ATC group and non-ATC group in body temperature and PH index (P > 0.05).(2)Use of uspension red blood cells, plasma, platelets and cryoprecipitate, ICU hospital stay in ATC group were all higher than those in non-ATC group. The difference of data was significant (P < 0.05).(3)The mortality rate of ATC group was 28. 2%, higher than that of non-ATC group 7. 5%.The difference was significant (P < 0.05). Conclusion The clinical prognosis of patients complicated with ATC is worse than those without the complication of ATC. It should be noted that early identification of risk factors for complication with ATC should be addressed as soon as possible to improve the prognosis of patients.