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目的:探讨创伤患者创伤性凝血病的相关因素与救治措施。方法:回顾性分析我院急救中心近3年收治的140例严重创伤患者的临床资料。根据是否合并低体温、休克、酸中毒进行分组。入院后30min内抽取外周静脉血检测血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)等指标,进行损伤严重程度(ISS)评分。结果:创伤患者PT>18s、APTT>60s、TT>15s与ISS评分具有相关性。低体温组较非低体温组、休克组较非休克组、酸中毒组较非酸中毒组PLT<100×109/L、FIB<1.5g/L、PT>18s、APTT>60s、TT>15s发生率均明显增多,差异有统计学意义(P<0.05)。结论:严重创伤患者血小板减少及凝血功能异常与损伤程度存在一定的相关性,监测创伤患者的PLT及凝血指标,及时采取治疗措施,对于严重创伤患者有重要意义。创伤合并低体温、休克及酸中毒者,更容易发生创伤性凝血病。
Objective: To explore the related factors and treatment of traumatic coagulopathy in trauma patients. Methods: A retrospective analysis of our hospital emergency center in the past 3 years admitted to 140 cases of severe trauma patients clinical data. According to whether combined with hypothermia, shock, acidosis were grouped. Peripheral venous blood samples were collected for PLT, PT, APTT, TT, fibrinogen (FIB) and other indexes within 30 min after admission Injury severity (ISS) score. Results: Traumatic patients with PT> 18s, APTT> 60s, TT> 15s were correlated with ISS score. Compared with non-hypoxemia group, hypothermia group and shock group than non-hypoxemia group, PLT <100 × 109 / L, FIB <1.5g / L, PT> 18s, APTT> 60s, TT> 15s The incidence was significantly increased, the difference was statistically significant (P <0.05). CONCLUSIONS: There are some correlations between thrombocytopenia and coagulation dysfunction in severe traumatic patients and the degree of injury. Monitoring PLT and coagulation indexes in trauma patients and taking timely treatment measures are of great significance to patients with severe trauma. Trauma combined with hypothermia, shock and acidosis, are more prone to traumatic coagulopathy.