目的探讨重症感染患儿凝血指标异常及其临床意义。方法选取儿童重症监护病房收治的160例重症感染患儿入院24 h内进行危重病评分,非危重组为26例,危重组为96例,极危重组38例;同时测定3个组患儿的凝血指标,分析患儿凝血指标与疾病严重程度和预后的关系。结果极危重组D-二聚体和FDP明显高于危重组,危重组高于非危重组,差异均有统计学意义(P<0.01),D-二聚体和FDP水平与危重评分呈负相关(P<0.01)。极危重组FIB明显低于危重组,差异有统计学意义(P<0.01);危重组和非危重组比较差异无统计学意义(P>0.05)。APTT各组间比较差异无统计学意义(P>0.05)。危重症组血小板计数明显高于非重症组,极危重组明显下降,差异有统计学意义(P<0.01)。死亡组PCIS评分、FIB和血小板计数明显低于存活组,D-二聚体和FDP明显高于存活组,差异均有统计学意义(P<0.01)。结论 D-二聚体、FDP和血小板计数与患儿疾病严重程度和预后相关,重症感染易并发凝血功能障碍。 Objective To investigate the abnormality of coagulation index in children with severe infection and its clinical significance. Methods A total of 160 children with severe infections admitted to the ICU were scored for critical illness within 24 hours after admission. There were 26 cases in the non-critically ill group, 96 in the critically ill group and 38 in the critically ill group. Coagulation index, analyze the relationship between coagulation index in children and disease severity and prognosis. Results The levels of D-dimer and FDP in the critically ill group were significantly higher than those in the critically ill group, but those in the critically ill group were significantly higher than those in the non-critically ill group (P <0.01). The levels of D-dimer and FDP in the critically ill group were negative Related (P <0.01). The critically ill group had significantly lower FIB than the critically ill group, with significant difference (P <0.01). There was no significant difference between the critically ill group and the non-critically ill group (P> 0.05). There was no significant difference between APTT groups (P> 0.05). The critical platelet count was significantly higher in non-critical group than in non-critical group, and significantly decreased in critical risk group (P <0.01). PCIS score, FIB and platelet count in death group were significantly lower than those in survival group, D-dimer and FDP in survival group were significantly higher than those in survival group (P <0.01). Conclusion D-dimer, FDP and platelet count are related to the severity and prognosis of children with severe infection complicated by coagulation dysfunction.