多器官功能障碍综合征患者的凝血功能变化及其意义

发布时间：2018-11-04 09:23

【摘要】：目的：回顾性分析多器官功能障碍综合征患者中凝血功能的变化，分析凝血功能障碍与APACHEII评分的关系，探讨凝血功能相关指标对评估多器官功能障碍综合征患者病情严重度的价值。方法：选取符合多器官功能障碍综合征诊断标准的45例患者，入院后24h内记录相关所需资料，计算GCS评分和APACHEII评分。根据APACHEII评分的分值分3组：评分10-20分为A组，评分20-30分为B组，评分大于30分为C组。根据患者的预后分为生存组和死亡组。根据凝血功能相关指标将患者分为凝血功能指标正常组和异常组。结果：1.凝血功能指标异常组与正常组比较：APACHEII评分高于后者；病死率大于后者。2.生存组与死亡组比较：死亡组的PT、APTT延长，血小板计数降低；死亡组的APACHEII评分高于生存组；死亡组的年龄大于生存组。3.不同APACHEII评分组间凝血功能指标的比较:C组的PT值、APTT值最高，B组次之，，A组最低，差别有统计学意义;A组的血小板计数最高，B组次之，C组最低，差别有统计学意义。结论：合并凝血功能指标异常的多器官功能障碍综合征患者病死率较高。老年患者易合并凝血功能指标异常且病情较重、病死率较高。凝血功能相关指标中PT、APTT及血小板计数与APACHEII评分有密切关系，随着APACHEII评分的升高PT、 APTT延长，血小板计数下降。PT、APTT及血小板计数的检测对判断多器官功能障碍综合患者预后及评估病情严重程度有一定价值。
[Abstract]:Objective: to retrospectively analyze the changes of coagulation function in patients with multiple organ dysfunction syndrome, and analyze the relationship between coagulation dysfunction and APACHEII score. To investigate the value of coagulation function related indexes in evaluating the severity of multiple organ dysfunction syndrome. Methods: 45 patients with multiple organ dysfunction syndrome were selected and the relevant data were recorded within 24 hours after admission. The GCS and APACHEII scores were calculated. According to the score of APACHEII score, it was divided into three groups: score 10-20 divided into group A, score 20-30 divided into group B, score more than 30 divided into group C. According to the prognosis, the patients were divided into survival group and death group. The patients were divided into normal group and abnormal group according to the indexes of coagulation function. Results: 1. Compared with the normal group, the APACHEII score was higher and the fatality rate was higher in the abnormal coagulation function group than that in the normal group. Survival group compared with death group: PT,APTT prolonged, platelet count decreased; APACHEII score of death group was higher than that of survival group; age of death group was larger than survival group. Comparison of coagulation function indexes among different APACHEII score groups: group C had the highest PT value, APTT value was the highest, group B was the second, group A was the lowest, the difference was statistically significant, the platelet count in group A was the highest, group B was the second, and group C was the lowest, the difference was statistically significant. Conclusion: the mortality of patients with multiple organ dysfunction syndrome with abnormal coagulation index is higher. The elderly patients are easy to be complicated with abnormal coagulation function index, and the disease is more serious, and the fatality rate is higher. PT,APTT and platelet count were closely related to APACHEII score in coagulation function related indexes. With the increase of APACHEII score, the platelet count decreased with the prolongation of PT, APTT. The detection of APTT and platelet count has certain value in judging the prognosis of patients with multiple organ dysfunction and evaluating the severity of the disease.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7

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