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目的:探讨多发性创伤患者凝血功能紊乱与病情严重程度及预后的关系。方法:选择入住ICU多发性创伤患者68例,检测凝血功能与血小板计数,记录伤后生命体征及器官功能变化进行和急性生理和慢性健康状况(A-PACHE)评分。结果:多发性创伤患者大多出现不同程度凝血功能改变,凝血功能改变明显者其APACHE评分也越高,病情越重,多器官功能障碍综合征(MODS)发生率越高。死亡组D-二聚体(D-dimer)明显高于生存组,PLT明显低于生存组,TT、APTT、PT明显较生存组延长。结论:监测多发性创伤患者存在凝血功能变化,对评估伤情、判断预后和指导早期治疗,以减少MODS及弥漫性血管内凝血(DIC)等严重并发症的发生,具有重要的临床意义。
Objective: To investigate the relationship between coagulopathy and severity of disease and prognosis in patients with multiple trauma. METHODS: Sixty-eight patients with multiple traumatic injuries admitted to ICU were enrolled in this study. Coagulation and platelet count were recorded. Vital signs, organ function changes and A-PACHE scores were recorded. Results: Most patients with multiple traumatic injury showed different degree of coagulation function changes, coagulation function significantly changed their APACHE score higher, the more serious the condition, the higher the incidence of multiple organ dysfunction syndrome (MODS). D-dimer in death group was significantly higher than that in survival group, PLT was significantly lower than that in survival group, TT, APTT and PT were significantly longer than those in survival group. Conclusion: It is of great clinical significance to monitor coagulation changes in patients with multiple traumatic injuries. It is of great clinical significance to assess the severity of the injury, to judge the prognosis and to guide the early treatment to reduce the occurrence of serious complications such as MODS and diffuse intravascular coagulation (DIC).