重度脓毒症患者凝血功能四项检测的临床应用分析

Clinical Application Analysis of Four Tests for Coagulation Function in Patients with Severe Sepsis

目的对重度脓毒症患者凝血功能四项检测的临床作用进行分析和研究。方法选择该院在2017年1月—2018年6月期间收治的60例重度脓毒症患者作为研究对象,以其最终结局为依据将其划分为两组,生存组有35例,死亡组有25例。对所有患者的四项凝血功能进行检测,并且对两组患者的四项凝血功能指标和APACHE II评分进行分析和比较。结果生存组的活化部分凝血活酶时间(39.59±4.22)s、凝血酶原时间(15.28±2.15)s、凝血酶时间(19.48±1.61)s指标明显低于死亡组(43.28±4.40)s、(17.26±1.51)s、(21.57±1.79)s,两组患者相比差异有统计学意义(t=2.273、2.945、2.328,P<0.05),生存组的纤维蛋白原水平(2.61±0.58)g/L明显高于死亡组(2.09±0.47)g/L,两组患者相比差异有统计学意义(t=2.481,P<0.05)。生存组的APACHEⅡ评分为(26.33±6.31)分,死亡组的APACHEⅡ评分为(19.98±6.78)分,生存组的APACHEⅡ评分明显高于死亡组,两组患者相比差异有统计学意义(P<0.05)。结论针对重度脓毒症患者实施凝血功能四项检测具有十分重要的意义,其有助于对重度脓毒症的临床诊断,而且对于其预后的评估也有重要参考作用。

Objective To analyze and study the clinical effects of four tests for coagulation function in patients with severe sepsis.Methods Sixty patients with severe sepsis admitted to our hospital from January 2017 to June 2018 were enrolled in the study.They were divided into two groups based on their final outcome.There were 35 patients in the survival group,and 25 cases in the death group.Four coagulation functions were measured in all patients,and four coagulation parameters and APACHE II scores were analyzed and compared between the two groups.Results The activated partial thromboplastin time(39.59±4.22)s,prothrombin time(15.28±2.15)s,thrombin time(19.48±1.61)s in the survival group were significantly lower than those of the death group(43.28±4.40)s,(17.26±1.51)s,(21.57±1.79)s,and the difference was statistically significant in the two groups(t=2.273,2.945,2.328,P<0.05).The fibrinogen level in the survival group was(2.61±0.58)g/L,which was higher than that of the death group(2.09±0.47)g/L,and the difference was statistically significant between the two groups(t=2.481,P<0.05).The APACHE Ⅱ score of the survival group was(26.33±6.31)points,which was significantly higher than that of the death group(19.98±6.78)points,and the difference between the two groups was statistically significant(P<0.05).Conclusion It is of great significance to carry out four tests for coagulation function in patients with severe sepsis.It is helpful for the clinical diagnosis of severe sepsis and it also has an important reference for the evaluation of prognosis.