多发伤患者创伤性凝血病危险因素分析

Risk factors of traumatic coagulation disease in patients with multiple trauma

目的:探讨多发伤患者创伤性凝血病危险因素。方法:回顾性分析2018年3月—2020年3月就诊的80例多发伤患者的临床资料,根据是否合并创伤性凝血病分组,分析多发伤患者发生创伤性凝血病的危险因素。结果:80例多发伤患者合并创伤性凝血病发生率为31.25%(25/80);合并创伤性凝血病组患者发生休克、低体温、多器官功能衰竭(MODS)、碳酸氢根(HCO-)<22 mmol/L比例以及创伤严重程度(ISS)评分高于无创伤性凝血病组;格拉斯哥昏迷评分(GCS)、血红蛋白(Hb)水平低于无创伤性凝血病组,差异均有统计学意义(P<0.05);经Logistic回归分析显示,休克、碳酸氢根HCO-<22 mmol/L、低体温、ISS评分是多发伤患者发生创伤性凝血病的独立危险因素(P<0.05且OR≥1)。结论:休克、HCO-<22 mmol/L、低体温、ISS与多发伤患者发生创伤性凝血病密切相关,可作为多发伤患者发生创伤性凝血病的独立危险因素,对于控制多发伤患者病情发展、改善患者预后具有指导意义。

Objective:To explore the risk factors of traumatic coagulopathy in patients with multiple trauma.Methods:The clinical data of 80 patients with multiple trauma admitted to hospital from March 2018 to March 2020 were retrospectively analyzed.The patients were divided into groups according to whether they were combined with traumatic coagulopathy,so as to analyze the risk factors of traumatic coagulation disease in patients with multiple trauma.result The incidence of traumatic coagulopathy was 31.25%(25/80);the incidence of shock,hypothermia,multiple organ failure(MODS),HCO-<22 mmol/L and injury severity score(ISS)in the group with traumatic coagulopathy were higher than those in the group without traumatic coagulopathy;the levels of glasgow coma scale(GCS)and hemoglobin(Hb)were lower in the group with traumatic coagulopathy Logistic regression analysis showed that shock,HCO-<22 mmol/L,hypothermia and ISS score were independent risk factors of traumatic coagulopathy in multiple trauma patients(P<0.05 and OR≥1).Conclusion:Shock,HCO-<22 mmol/L,hypothermia and ISS are closely related to the occurrence of traumatic coagulopathy in patients with multiple trauma,which can be used as independent risk factors of traumatic coagulation disease in patients with multiple trauma.It has guiding significance for controlling the development of multiple trauma patients and improving the prognosis of patients.