凝血功能四项检测在评估ICU重症休克患者预后的价值

目的研究凝血功能四项检测在评估ICU重症休克患者预后中的价值。方法以2014年3月~2016年3月ICU收治的125例重症休克患者为研究对象,依据28 d预后情况将患者分为存活组(95例)与死亡组(30例),比较分析两组患者APACHEII评分、凝血四项检测、乳酸水平等相关资料,并通过Logistic多因素回归分析影响重症休克患者预后(死亡)的独立危险因素。结果存活组患者APACHEII评分、乳酸水平、PT、Fbg、D-D水平分别为(23.35±3.08)分、(2.18±2.40)mmol/L、(13.05±1.80)s、(3.59±1.72)g/L、(4.90±10.10)mg/L,较死亡组的(28.35±7.12)分、(4.58±4.47)mmol/L、(16.14±1.50)s、(2.80±1.75)g/L、(10.88±17.26)mg/L差异有统计学意义(P0.05)。Logistic回归分析显示ICU重症休克患者预后独立危险因素为APACHEII评分、乳酸水平、D-D水平。结论凝血功能四项检测对ICU重症休克患者预后评估有一定的价值,同时乳酸水平、D-D水平可作为重症休克患者死亡独立危险因素。

Value of Detecting Four Items of Coagulation Function in Evaluating the Prognosis of Patients with Severe Shock in ICU

Objective To study the value of detecting four items of coagulation function in evaluating the prognosis of patients with severe shock in ICU .Methods 125 patients with severe shock treated in our hospital between March 2014 and March 2016 were enrolled in the study .The patients were divided into survival group(95 cases)and the death group (30 cases) according to the 28 d prognosis.APACHEII score, detection of the four items of coagulation function , lactic acid level , and so on were analyzed and compared between the two groups .The independent risk factors influencing the prognosis ( death ) of patients with severe shock were analyzed by Logistic regression analysis .Results There were significant differences in APACHE II score,lactic acid level,PT,Fib and D-D level between survival group (23.35 ±3.08),(2.18 ±2.40) mmol/L,(13.05 ±1.80)s and(3.59 ±1.72)g/L,(4.90 ±10.10)mg/L]and the death group(28.35 ± 7.12),(4.58 ±4.47) mmol/L,(16.14 ±1.50) s,(2.80 ±1.75) g/L,(10.88 ±17.26) mg/L)] ( P <0.05).Logistic regression analysis showed that the independent risk factors for the prognosis of patients with severe shock in ICU included APACHEII score ,lactic acid level and D-D level .Conclusion Detection of the four items of coagulation function is of certain value in evaluating the prognosis of patients with severe shock in ICU.Lactic acid level and D-D level can be used as the independent risk factors of death .