不同程度创伤患者早期钙离子浓度临床观察

发布时间：2018-11-21 13:42

【摘要】：目的:对创伤患者受伤早期血浆钙离子浓度进行测定，探究不同受伤程度下患者钙离子浓度的差异，为临床创伤后低钙血症患者的治疗提供依据。 方法: 1一般资料 本实验观察自2012年1月至2013年3月收住我科的创伤患者。纳入及排除标准：既往体健，无心肺疾病史，排除肝硬化，慢性肾功能衰竭，恶性肿瘤，甲状旁腺功能异常，垂体受损,血红蛋白小于7g/dl需输血及超过24小时送入我科者。符合条件者共计82例，其中男56例，女26例；年龄范围18岁至60岁；交通事故伤60例；坠落伤16例；其他如打架斗殴伤，挤压伤等6例。存活76例，死亡6例。 2试验方法 对于符合试验标准的患者，按照检测要求入院后即刻抽取静脉血三份送检，通过COBOS B221血气分析仪测定钙离子浓度，以三次钙离子浓度的平均值作为统计数据。依据国际通用的创伤严重度评分（ISS）对患者进行评分及分组。所有患者入院积极处理原发疾病，维持循环稳定并予以相应的对症、支持治疗。观察各组患者预后情况，，统计各组病人的病死率。 3统计分析 运用SPSS13.0统计分析软件进行统计学描述及分析，计量数据用均数±标准差表示，ISS评分各组间钙离子水平差异比较采用方差分析，两组间比较采用t检验，病死率组间比较用卡方检验。 结果： 符合条件者共计82例，其中男56例，女26例；年龄范围18岁至60岁；交通事故伤60例；坠落伤16例；其他如打架斗殴伤，挤压伤等6例。存活76例，死亡6例。根据ISS评分进行分组：A组（ISS16分）25例,B组（16分≤ISS25分）27例，C组（ISS≥25分）30例。创伤患者早期钙离子浓度水平与正常生理状态下比较明显降低，创伤程度越重的患者其钙离子浓度越低。存活组与病死组之间钙离子浓度及ISS评分存在显著差异。 结论: 1创伤患者早期存在电解质紊乱，表现为低钙血症，离子钙浓度降低的水平与创伤严重程度及预后有一定关系。 2离子钙水平在临床可以作为一项重要指标或者结合其他指标对创伤患者进行早期评估及指导临床治疗。
[Abstract]:Objective: to investigate the difference of plasma calcium concentration in patients with trauma at the early stage of trauma, and to provide evidence for the treatment of patients with hypocalcemia after trauma. Methods: 1 General data from January 2012 to March 2013 were observed. Inclusion and exclusion criteria: past physical fitness, no history of heart disease, exclusion of cirrhosis, chronic renal failure, malignant tumor, abnormal parathyroid function, impaired pituitary gland, hemoglobin less than 7g/dl need blood transfusion and more than 24 hours to be sent to our department. A total of 82 cases were eligible, including 56 males and 26 females, aged from 18 to 60 years old, 60 cases of traffic accident injury, 16 cases of falling injury, 6 cases of other cases such as fight and fight injury, crush injury and so on. There were 76 cases of survival and 6 cases of death. 2 for the patients who met the test standard, three samples of venous blood were collected immediately after admission according to the test requirements. The calcium ion concentration was measured by COBOS B221 blood gas analyzer, and the average value of the three times calcium ion concentration was taken as the statistical data. Patients were graded and grouped according to the international trauma severity scale (ISS). All patients were admitted to hospital to actively deal with primary diseases, maintain stable circulation and corresponding symptomatic, supportive treatment. The prognosis and mortality of each group were observed. 3The statistical analysis was described and analyzed by SPSS13.0 software. The measurement data were expressed as mean 卤standard deviation. The difference of calcium level in ISS score was compared with variance analysis, and t test was used in the comparison between the two groups. The mortality rate was compared by chi-square test. Results: a total of 82 cases were qualified, including 56 males and 26 females, aged from 18 to 60 years old, 60 cases of traffic accident injury, 16 cases of falling injury, 6 cases of other cases such as fight injury, crush injury and so on. There were 76 cases of survival and 6 cases of death. According to ISS score, there were 25 cases in group A (ISS16), 27 cases in group B (16 鈮

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