中华损伤与修复杂志（电子版）
中華損傷與脩複雜誌（電子版）
중화손상여수복잡지（전자판）
Chinese Journal of Injury Repair and Wound Healing
2012年
2期
40-43,48
,共5页
夏正国%徐庆连%唐益忠%蔡晨%牛锦城
夏正國%徐慶連%唐益忠%蔡晨%牛錦城
하정국%서경련%당익충%채신%우금성
烧伤%血小板计数%危重病%急性生理及慢性健康状况评分Ⅱ%全身炎症反应综合征
燒傷%血小闆計數%危重病%急性生理及慢性健康狀況評分Ⅱ%全身炎癥反應綜閤徵
소상%혈소판계수%위중병%급성생리급만성건강상황평분Ⅱ%전신염증반응종합정
Burns%Platelet count%Critical illness%Acute Physiology and Chronic Health Evaluation Ⅱ scores%Systemic inflammatory response syndrome
目的 研究危重(重度、特重度)烧伤患者血小板计数的动态变化,及其对病情严重程度和预后的判断价值.方法 以安徽医科大学第一附属医院烧伤科2007年至2010年收治的131例危重烧伤患者作为研究对象,并按有无发生全身炎症反应综合征(SIRS)分为SIRS组和非SIRS组,SIRS组按入院后存活情况分为SIRS生存组和SIRS死亡组.测定入院第1、4、7、10、14天血小板计数的动态变化,同时记录患者入院后24h内急性生理与慢性状况评分Ⅱ(APACHEⅡ).结果 各组血小板计数于入院第4天短暂下降后持续上升,入院第4、7、10、14天,非SIRS组血小板计数均显著高于SIRS组(均P＜0.05),SIRS生存组血小板计数于各时相点均显著高于SIRS死亡组(P＜0.05).非SIRS组APACHEⅡ评分显著低于SIRS组(P＜0 05),SIRS生存组APACHEⅡ评分显著低于SIRS死亡组(P＜0.05).以住院存活或死亡为应变量的Logistic回归分析显示,APACHEⅡ评分及血小板减少症与危重烧伤患者预后密切相关(OR值分别为l 547、0.015,P值分别为0 031、0.046).结论 血小板计数的动态变化可作为预测危重烧伤患者病情变化及预后的一项重要指标.
目的 研究危重(重度、特重度)燒傷患者血小闆計數的動態變化,及其對病情嚴重程度和預後的判斷價值.方法 以安徽醫科大學第一附屬醫院燒傷科2007年至2010年收治的131例危重燒傷患者作為研究對象,併按有無髮生全身炎癥反應綜閤徵(SIRS)分為SIRS組和非SIRS組,SIRS組按入院後存活情況分為SIRS生存組和SIRS死亡組.測定入院第1、4、7、10、14天血小闆計數的動態變化,同時記錄患者入院後24h內急性生理與慢性狀況評分Ⅱ(APACHEⅡ).結果 各組血小闆計數于入院第4天短暫下降後持續上升,入院第4、7、10、14天,非SIRS組血小闆計數均顯著高于SIRS組(均P＜0.05),SIRS生存組血小闆計數于各時相點均顯著高于SIRS死亡組(P＜0.05).非SIRS組APACHEⅡ評分顯著低于SIRS組(P＜0 05),SIRS生存組APACHEⅡ評分顯著低于SIRS死亡組(P＜0.05).以住院存活或死亡為應變量的Logistic迴歸分析顯示,APACHEⅡ評分及血小闆減少癥與危重燒傷患者預後密切相關(OR值分彆為l 547、0.015,P值分彆為0 031、0.046).結論 血小闆計數的動態變化可作為預測危重燒傷患者病情變化及預後的一項重要指標.
목적 연구위중(중도、특중도)소상환자혈소판계수적동태변화,급기대병정엄중정도화예후적판단개치.방법 이안휘의과대학제일부속의원소상과2007년지2010년수치적131례위중소상환자작위연구대상,병안유무발생전신염증반응종합정(SIRS)분위SIRS조화비SIRS조,SIRS조안입원후존활정황분위SIRS생존조화SIRS사망조.측정입원제1、4、7、10、14천혈소판계수적동태변화,동시기록환자입원후24h내급성생리여만성상황평분Ⅱ(APACHEⅡ).결과 각조혈소판계수우입원제4천단잠하강후지속상승,입원제4、7、10、14천,비SIRS조혈소판계수균현저고우SIRS조(균P＜0.05),SIRS생존조혈소판계수우각시상점균현저고우SIRS사망조(P＜0.05).비SIRS조APACHEⅡ평분현저저우SIRS조(P＜0 05),SIRS생존조APACHEⅡ평분현저저우SIRS사망조(P＜0.05).이주원존활혹사망위응변량적Logistic회귀분석현시,APACHEⅡ평분급혈소판감소증여위중소상환자예후밀절상관(OR치분별위l 547、0.015,P치분별위0 031、0.046).결론 혈소판계수적동태변화가작위예측위중소상환자병정변화급예후적일항중요지표.
Objective To explore the value of the dynamic changes of platelet count in assessing the severity and prognosis of critically burned patients.Methods One hundred and thirty-one critically burned patients were divided into two groups:systemic inflammatory response syndrome (SIRS) and non-SIRS,according to the criteria of SIRS.SIRS group was classified as survial group and death group according to the outcome.Dynamic changes of platelet count and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) scores were recorded after hospitalization for 1,4,7,10,14 days.Results The platelet count of each group decreased significantly in the fourth day after admission,then continued to increase.The platelet count in non-SIRS group was higher than that in SIRS group (P＜ 0.05) on the 4,7,10,14 days.The platelet count in survial group at each timepoint was higher than that in death group ( P ＜0.05).The APACHE Ⅱ scores in non-SIRS group were significantly lower than those in SIRS group (P ＜0.05 ),The APACHE Ⅱ scores in survial group were also lower than those in death group ( P ＜ 0.05 ).Logistic regression analysis with hospital mortality as dependent variable showed that APACHE Ⅱ scores and the occurrence of thrombocytopenia were significantly related with hospital mortality of critically burned patients.Conclusion The dynamic changes of blood platelet count can be an important index in predicting the severity and prognosis of critically burned patients.
