严重创伤患者凝血纤溶特点分析

目的 探讨严重创伤患者凝血纤溶功能障碍,寻求反映创伤患者凝血纤溶功能障碍的敏感指标.方法 选取54例严重创伤患者,分别在手术前及手术后第1天和第5天测定其血浆凝血酶-抗凝血酶复合物(TAT)、凝血酶原裂解片段(F1 2)、D-二聚体、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)5项指标水平,并与正常对照组(50例)进行比较.结果 手术前患者组与对照组相比F1 2、TAT、D-二聚体差异均有统计学意义(P<0.05);手术后第1天这3项指标均达3次结果 峰值(P<0.01),手术后第4天3项指标均稍有下降,但差异无统计学意义;3次测定结果 中,APTT、PT结果 与正常对照组差异均无统计学意义.结论 严重创伤患者F1 2、TAT、D-二聚体升高,提示患者处于高凝状态,并有继发性纤溶亢进,在反映严重创伤患者凝血纤溶功能障碍中,这些分子指标优于常规凝血象检查.

Features of the coagulation and fibrinolysis in patients with severe trauma

Objective To find the sensitive index to reflect the coagulation and fibrinolysis dysfuncation in severe trauma patients.MethodsObserve the dynamic data of F1 2,TAT and D-dimer,APTT,PT Fib in vein blood of 54 patients.ResultsCompared with the control group,F1 2,TAT and D-dimer increased obviously before operation(P <0.05),and they reached the peak one day after operation,then they decreased a little but showed no significant difference with 4 days after operation.The levels of APTT and PT showed no difference with the control group.ConclusionF1 2,TAT and D-dimer are superior to APTT,PT in reflection of the coagulation and fibrinolysis dysfuncation in severe trauma patients.