联合检测TEG和CCTs对创伤严重程度的临床诊断研究

目的探讨血栓弹力图(TEG)和常规凝血指标(CCTs)联合检测对创伤严重程度的临床诊断方法和意义。方法选取2018年3月至2020年3月上饶市人民医院收治的40例(观察组)多发创伤患者,及同期健康体检者40例(对照组),入院时对观察组患者采用坎帕拉创伤评分(kampala trauma score,KTS)进行伤情初步分级测评,将观察组患者分为轻症组、中症组和重症组,于伤后10 h内对4组行CCTs和TEG检查,并对检查指标的差异性进行评估,以精确诊断患者凝血功能和创伤严重程度。结果 TEG检验各指标R值、K值、α角和MA值]比较,轻症组、中症组、重症组与对照组差异有统计学意义(P<0.05),轻症组、中症组和重症组比较差异有统计学意义(P<0.05),轻症组和中症组仅MA值差异有统计学意义(P<0.05);轻症组、中症组、重症组与对照组CCTs检验各指标PT、APTT、TT、FIB和D-D]比较差异有统计学意义(P<0.05),轻症组、中症组和重症组差异有统计学意义(P<0.05),轻症组和中症组间,随着患者创伤严重程度提升,PT、FIB和D-D差异有统计学意义(P<0.05)。结论 TEG、CCTs在多发创伤患者和健康体检者区别判断方面均有显著特异性,联合检测TEG和CCTs可全面诊断创伤多发患者的严重程度,具有临床推广价值。

Clinical diagnosis of trauma severity by combined detection of TEG and CCTs

Objective To explore the clinical diagnosis method and significance of thecombination of thromboelastography(TEG)and conventional coagulation function(CCTs)for the severity of trauma.Methods From March 2018 to March 2020,40 patients(observation group)with multiple traumas and 40 patients(control group)with physical examination at the same time were selected from Shangrao People's Hospital.The patients in the observation group were assessed with Kampala trauma score(KTS)on admission.The patients in the observation group were divided into mild,middle and severe groups,CCTs and TEG were performed in 4 groups within 10 hours,and the differences of the examination indexes were evaluated to accurately diagnose the coagulation function and the severity of trauma.Results Compared with the control group,the light group,the middle group and the severe group had statistical significance(P<0.05),the light group,the middle group and the severe group had statistical significance(P<0.05),the light group and the middle group only MA had statistical significance(P<0.05),and the CCTs test indexesPT,APTT,TT,FIB and D-D]had statistical significance,there were significant differences between the disease group,the middle disease group,the severe group and the control group(P<0.05),the light group,the middle group and the severe group had statistical significance(P<0.05),Between the light group,the middle group,as the severity of trauma increased,the differences in PT,FIB and D-D were statistically significant(P<0.05).Conclusion TEG and CCTs have significant specificity in the differential judgment between patients with multiple trauma and healthy people.Combined detection of TEG and CCTs can comprehensively diagnose the severity of patients with multiple trauma,which has stronger clinical value.