西宁地区外伤性脾切除患者术后血小板变化的临床研究

发布时间：2018-04-23 17:18

本文选题：西宁地区 + 脾切除术后　；参考：《青海大学》2017年硕士论文

【摘要】：目的研究西宁地区外伤性脾切除患者术后各项血小板参数随时间变化的趋势,并分析术后第14天PLT的影响因素。方法回顾性分析2013年4月至2016年12月于青海省人民医院急诊外科行脾切除术的外伤性脾破裂患者,按照统一的纳入及排除标准随机收集病例资料,分别记录其术前、术后第1天、第3天、第7天、第10天、第14天的血小板参数(PLT、MPV、PCT、PDW),分析各项参数随时间变化的趋势。按性别、年龄、民族、伤情、脾损伤分级、是否休克、输血量、损伤距手术的时间、是否合并感染、术前PLT等因素进行分类,分析术后第14天PLT的影响因素。结果1.西宁地区外伤性脾切除患者术后2周内PLT、PCT随天数增加逐渐升高,不同天数间两两比较差异均有统计学意义(p0.05);MPV、PDW随天数增加逐渐降低,术后第1天与术前比较差异无统计学意义(p0.05),其余不同天数间两两比较差异均有统计学意义(p0.05)。2.单因素分析结果显示年龄、伤情、输血量、是否合并感染是西宁地区外伤性脾切除患者术后第14天PLT的影响因素(p0.05);性别、民族、脾损伤分级、损伤距手术的时间对术后第14天PLT无影响(p0.05);是否休克对术后第14天PLT的影响需纳入多因素分析中进一步明确。3.多因素分析结果显示年龄、伤情、输血量、是否合并感染是西宁地区外伤性脾切除患者术后第14天PLT的影响因素(p0.05),是否休克对术后第14天PLT无影响(p0.05),多元线性回归方程为Y=724.890-3.305×年龄+65.839×伤情+0.074×输血量-66.231×是否合并感染。4.Pearson相关分析结果显示术后第14天PLT与术前PLT呈正相关(r=0.450,p0.05)。结论1.西宁地区外伤性脾切除患者术后2周内PLT与PCT随天数增加逐渐升高,MPV与PDW术后1天以后随天数增加逐渐降低。2.年龄、伤情、输血量、是否合并感染是西宁地区外伤性脾切除患者术后第14天PLT升高的影响因素。3.年轻患者、伤情越重、输血越多、术前PLT越高的患者术后第14天PLT可能也越高,感染对术后第14天PLT升高可能有一定的抑制作用。
[Abstract]:Objective to study the changes of platelet parameters with time in patients with traumatic splenectomy in Xining area and analyze the influencing factors of PLT on the 14th day after operation. Methods from April 2013 to December 2016, patients with traumatic splenic rupture undergoing splenectomy in emergency surgery department of Qinghai Provincial people's Hospital were retrospectively analyzed. The data of the patients were collected randomly according to the unified inclusion and exclusion criteria, and the preoperative data were recorded respectively. The platelet parameters were analyzed on the first day, 3rd day, 7th day, 10th day and 14th day after operation. Factors such as sex, age, nationality, injury condition, grade of spleen injury, shock, blood transfusion volume, time from injury to operation, co-infection and preoperative PLT were classified. The influencing factors of PLT on the 14th day after operation were analyzed. Result 1. There was no significant difference between the first day after operation and that before operation (P 0.05), but there was significant difference between the other days (P 0.05). Univariate analysis showed that age, injury, blood transfusion and co-infection were the influencing factors of PLT in patients with traumatic splenectomy in Xining area on the 14th day after operation. The time from injury to operation had no effect on PLT on the 14th day after operation, and the effect of shock on PLT on the 14th day after operation should be further clarified in multivariate analysis. The results of multivariate analysis showed that age, injury, blood transfusion, 4. Pearson correlation analysis showed that there was a positive correlation between PLT and preoperative PLT on the 14th day after operation. Conclusion 1. PLT and PCT increased gradually with the increase of days in patients with traumatic splenectomy in Xining area. Age, injury, blood transfusion and co-infection were the influencing factors for the increase of PLT in patients with traumatic splenectomy in Xining area on the 14th day after operation. In young patients, the more serious the injury, the more blood transfusion, the higher the preoperative PLT, the higher the PLT may be on the 14th day after operation. Infection may have a certain inhibitory effect on the increase of PLT on the 14th day after operation.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.6

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