多发性创伤患者凝血功能改变与预后的关系

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。

Changes of Coagulation Functions in Patients with Multiple Trauma and Its Relationship with Prognosis

Objective：To investigate the relationship between the severity,prognosis and the coagulation dysfunction of patients with multiple trauma. Methods ： 68 cases of multiple trauma were investigated. Levels of platelet count （PLT） ,D-dimer（DD） ,prothrombin time（PT） ,activated partial thromboplastin time （APTT） ,fibrinogen （FBG） and A- PACHE Ⅱ scores were determined at the admission day. Result ： There were different degree dysfunctions of coagulation in the patients with multiple trauma. The more dramatical changes of coagulation dysfunction, the higher APACHE Ⅱ scores of patients,and the incidence of multiple organs dysfunction syndrome （MODS） were higher. The level of platelet was lower and the level of D-direct was dramatically higher in death group than those of survival group,while PT,APTT and TT were obviously prolonged. Conclusion：The coagulation dysfunction of multiple traumatic patients is associated with the severity and prognosis of the illness.