骨折伴多发伤患者血小板计数变化与预后的关系

发布时间：2019-08-24 20:17

【摘要】：目的研究骨折伴多发伤患者血小板计数变化与预后的关系。方法回顾性分析我院2012年8月至2014年8月骨折伴多发伤患者90例,根据血小板计数(PLT)变化情况将患者分为PLT降低组31例和PLT正常组59例。比较两组患者创伤严重等级评分(ISS)、急性生理学与慢性健康状况III评分(APACHE III)以及全身炎性反应、多器官功能障碍综合症、多器官功能衰竭、感染死亡的发生率,比较最终死亡的患者与存活患者血小板变化情况。结果PLT降低组患者的ISS评分与APACHE III评分较PLT正常组均显著较高(P0.05);PLT降低组全身炎性反应、多器官功能障碍综合症、多器官功能衰竭发生率分别为77.42%、83.87%、41.94%较PLT正常组54.24%、59.32%、15.25%显著较高(P0.05);PLT降低组死亡率为29.03%较PLT正常组5.08%显著较高(P0.05);死亡组患者PLT最低值与均值较存活组显著较低(P0.05);死亡组患者血小板最早下降时间较存活组显著较早(P0.05);血小板下降持续时间较存活组显著较长(P0.05)。结论骨折伴多发伤患者血小板急剧下降会导致患者并发多种全身性炎症及功能障碍,患者死亡率高,血小板持续性降低和血小板计数快速的下降预示着患者预后不佳。
[Abstract]:Objective to study the relationship between platelet count and prognosis in patients with fracture and multiple injuries. Methods from August 2012 to August 2014, 90 patients with fracture and multiple injuries in our hospital were analyzed retrospectively. according to the changes of platelet count (PLT), the patients were divided into PLT reduction group (n = 31) and normal PLT group (n = 59). The incidence of trauma severity score (ISS), acute physiology and chronic health status III score (APACHE III), systemic inflammatory reaction, multiple organ dysfunction syndrome, multiple organ failure, infection death were compared between the two groups, and the platelet changes between the final dead patients and the surviving patients were compared. Results the ISS score and APACHE III score of patients with decreased PLT were significantly higher than those of normal PLT group (P 0.05). The incidence of systemic inflammatory reaction, multiple organ dysfunction syndrome and multiple organ failure in); PLT decreased group was 77.42%, 83.87%, 41.94%, 54.24%, 59.32% and 15.25%, respectively (P 0.05). The mortality of PLT decreased group (29.03%) was significantly higher than that of PLT normal group (5.08%), the lowest and mean value of PLT in death group was significantly lower than that in survival group (P 0.05), the earliest platelet decline time in death group was significantly earlier than that in survival group (P 0.05), and the duration of platelet decline was significantly longer than that in survival group (P 0.05). Conclusion the sharp decrease of platelet in patients with fracture and multiple injuries will lead to a variety of systemic inflammation and dysfunction. The mortality of patients is high. The persistent decrease of platelet and the rapid decrease of platelet count indicate that the prognosis of the patients is not good.
【作者单位】：内蒙古医科大学第二附属医院检验科;内蒙古医科大学附属医院输血科;
【分类号】：R683;R446.1

【相似文献】