中国急救复苏与灾害医学杂志
中國急救複囌與災害醫學雜誌
중국급구복소여재해의학잡지
CHINA JOURNAL OF EMERGENCY RESUSCITATION AND DISASTER MEDICINE
2015年
7期
652-655
,共4页
血小板减少症(TCP)%脓毒症%弥散性血管内凝血(DIC)%重症监护病房(ICU)
血小闆減少癥(TCP)%膿毒癥%瀰散性血管內凝血(DIC)%重癥鑑護病房(ICU)
혈소판감소증(TCP)%농독증%미산성혈관내응혈(DIC)%중증감호병방(ICU)
Thrombocytopenia%Sepsis%Disseminated intravascular coagulation (DIC)%ICU
目的：调查重症监护病房(ICU)血小板减少症（TCP）发生率、预后，分析其危险因素及可能机制。方法收集2012年10月~2013年10月217例ICU患者临床资料，调查血小板减少症的发生率，对其相关危险因素进行Logistic逐步回归分析，并探讨其可能机制。结果发现血小板减少症患者76例（35.0%），病死率38.2%，显著高于非血小板减少症患者病死率5.0%（P<0.01）。脓毒症、出血或输血、急性生理和慢性健康估测评分II（APACHE II）>15是血小板减少症的独立危险因素。纠正血小板减少能降低血小板减少症患者的病死率。血小板减少症患者当中DIC发生率为39.5%（30例）。结论脓毒症是主要的独立危险因素，ICU中血小板减少患者病死率更高。纠正血小板减少能够改善患者预后。
目的：調查重癥鑑護病房(ICU)血小闆減少癥（TCP）髮生率、預後，分析其危險因素及可能機製。方法收集2012年10月~2013年10月217例ICU患者臨床資料，調查血小闆減少癥的髮生率，對其相關危險因素進行Logistic逐步迴歸分析，併探討其可能機製。結果髮現血小闆減少癥患者76例（35.0%），病死率38.2%，顯著高于非血小闆減少癥患者病死率5.0%（P<0.01）。膿毒癥、齣血或輸血、急性生理和慢性健康估測評分II（APACHE II）>15是血小闆減少癥的獨立危險因素。糾正血小闆減少能降低血小闆減少癥患者的病死率。血小闆減少癥患者噹中DIC髮生率為39.5%（30例）。結論膿毒癥是主要的獨立危險因素，ICU中血小闆減少患者病死率更高。糾正血小闆減少能夠改善患者預後。
목적：조사중증감호병방(ICU)혈소판감소증（TCP）발생솔、예후，분석기위험인소급가능궤제。방법수집2012년10월~2013년10월217례ICU환자림상자료，조사혈소판감소증적발생솔，대기상관위험인소진행Logistic축보회귀분석，병탐토기가능궤제。결과발현혈소판감소증환자76례（35.0%），병사솔38.2%，현저고우비혈소판감소증환자병사솔5.0%（P<0.01）。농독증、출혈혹수혈、급성생리화만성건강고측평분II（APACHE II）>15시혈소판감소증적독립위험인소。규정혈소판감소능강저혈소판감소증환자적병사솔。혈소판감소증환자당중DIC발생솔위39.5%（30례）。결론농독증시주요적독립위험인소，ICU중혈소판감소환자병사솔경고。규정혈소판감소능구개선환자예후。
Objective To investigate the incidence of thrombocytopenia in ICU, its risk factors, prognosis, as well as the possible mechanisms associated with thrombocytopenia. Methods An analysis was conducted on a total of 217 ICU patients who were admitted from Oct. 2012 to Oct 2013. The risk factors for thrombocytopenia were analyzed by the stepwise logistic regression analysis, as well as the mechanisms involved. Results A total of 76 patients (35%) were found complicated by thrombocytopenia, with a mortality rate of 38% comparing with 5.0% mortality rate in non-thrombocytopenic patients (p<0.01). Sepsis, episodes of bleeding or transfusions, and an acute physiology and chronic health evaluation (APACHE) II score of > 15 were the independent risk factors identified for thrombocytopenia. The correction of thrombocytopenia was a protective factor in reducing mortality for thrombocytopenic patients. Disseminated intravascular coagulation was found in 39.5% of thrombocytopenic patients. Conclusions Sepsis was identified for the major independent risk factor. Thrombocytopenic patients have a higher ICU mortality due to the severity of overall clinical status. Bone marrow examination could be diagnostic when no obvious causes are identified. Thrombocytopenia probably reflects the severity and course of an underlying pathologic condition, as its correction appears to be a good prognostic factor.
