特重度烧伤患者凝血功能动态变化特点及与预后的关系

The relationship between coagulation function in severe burn patients dynamic changes and prognosis

目的：探讨特重度烧伤患者凝血功能动态变化规律以及对患者预后可能的影响。方法：选取特重度以上烧伤患者60例，根据患者治疗结局分为存活组（57例）和死亡组（3例），观察两种患者在入院15d内纤维蛋白原和D-二聚体变化情况。结果：死亡组在住院3d、5d、9d、11d、13d，15d纤维蛋白原水平明显高于存活组，差异有统计学意义，在住院5d、9d、11d、13d，15dD-二聚体水平明显高于存活组，差异有统计学意义；存活组在入院后纤维蛋白原和D-二聚体水平开始上升，至入院5d达到最高峰后开始下降，至第15d始终处于下降状态；死亡组在入院后纤维蛋白原和D-二聚体水平同样上升，并至第5d达到最高值后开始下降，但在第9d又开始上升，至11d达到最高值开始下降，至15d一直处于下降状态。结论：凝血功能异常严重的患者更容易出现病情恶化甚至死亡，而死亡较常集中在入院后3～5d以及9～11d。

Objective To investigate the blood coagulation function in severe burn patients dynamic changes and the pos-sible effect on the prognosis of the patients. Methods 60 patients with severe burns,According to the outcomes of patients were divided into survival group(57 cases)and death group(3 cases),Observation of two kinds of fibers in patients within 15d after admission of fibrinogen and D-two dimer changes. Results The death group in hospital 3D,5D,9D,11d,13D,15d and fibrinogen levels were significantly higher than the survival group,The difference had statistically significant,In the hospital, 9D,11d,5D 13D,two 15dD-dimer levels were significantly higher than the survival group,The difference had statistically sig-nificant;The survival group after admission in fibrinogen and D-dimer levels began to rise two,Admission to 5D after reaching the peak began to decline,The 15d is always in a state of decline;The death group after admission in fibrinogen and D-dimer levels also increased,And to the 5D reached the highest value began to decline after,But in the beginning of the first 9d rise, To achieve the maximum value of 11d began to decline,15d has been in a state of decline. Conclusion The abnormal coagula-tion function in severe patients more prone to deterioration and even death,But death is often concentrated in 3~5d and 9~11d after admission.