ICU菌血症老年患者血小板与凝血功能检测的临床意义研究

发布时间：2018-06-17 12:16

本文选题：重症监护病房 + 老年患者　；参考：《中华医院感染学杂志》2016年02期

【摘要】：目的观察和分析重症监护病房(ICU)菌血症老年患者血小板(PLT)及凝血功能检测的意义,为制定该类医院感染的预防控制策略提供客观依据。方法选取2013年1月-2014年12月的80例ICU菌血症老年患者作为研究对象,根据其预后将其分为存活组52例和死亡组28例,对患者入院时、血培养首次呈阳性时的外周血PLT及部分活化的凝血酶原时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和纤维蛋白原(FIB)等凝血功能指标进行检测和比较;应用SPSS 13.0软件进行统计分析。结果与入院时比较,患者在血培养首次呈阳性时的PLT显著下降,而APTT、PT和FIB水平显著升高,差异均有统计学意义(t=8.346、7.112、6.034、5.367,P0.05);不同病原菌感染患者PLT及凝血功能指标的差异均无统计学意义;死亡组患者的PLT计数显著低于存活组而APTT显著高于存活组,差异均有统计学意义(t=11.015、8.673,P0.05),多因素logistic回归分析结果显示,患者死亡与年龄、PLT和APTT水平具有相关性,差异均有统计学意义(P0.05)。结论 ICU菌血症老年患者表现为PLT的损耗和凝血功能的下降,PLT计数及APTT水平与患者的预后相关,检测PLT计数和凝血功能指标可用于辅助该类患者的早期诊断和预后预测。
[Abstract]:Objective to observe and analyze the significance of platelet PLT and coagulation function in elderly patients with ICU bacteremia in intensive care unit (ICU), and to provide an objective basis for the prevention and control of this kind of nosocomial infection. Methods from January 2013 to December 2014, 80 elderly patients with ICU bacteremia were divided into survival group (52 cases) and death group (28 cases) according to their prognosis. The blood coagulation function indexes such as PLT and activated prothrombin time (APTTT), prothrombin time (PTT), thrombin time (TTT) and fibrinogen (FIBs) in the first positive blood culture were detected and compared, and SPSS 13.0 software was used for statistical analysis. Results compared with the patients at admission, PLT decreased significantly at the first time of positive blood culture, while the levels of APTTT and FIB increased significantly, the differences were statistically significant (P 0.05), and there was no significant difference in PLT and coagulation function in patients with different pathogenic bacteria infection. The PLT count in the death group was significantly lower than that in the surviving group, and the APTT was significantly higher than that in the surviving group. The difference was statistically significant (P 0.05). The multivariate logistic regression analysis showed that there was a correlation between the death and the age of PLT and APTT, and the difference was statistically significant (P 0.05). Conclusion the PLT loss and the decrease of coagulation function in ICU geriatric patients are related to the prognosis of the patients. The detection of PLT count and coagulation function index can be used to assist the early diagnosis and prognosis prediction of this kind of patients.
【作者单位】：吉林大学第一医院日间观察病房;吉林大学第一医院医务部;吉林大学第一医院感染控制科;
【基金】：吉林省科学技术厅基金资助项目(20150101220JC)
【分类号】：R459.7;R515.3

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