Study on the effects of blood coagulation function on the severity and prognosis of the patients with multi-trauma
10.3969/j.issn.1009-0754.2017.02.025
- VernacularTitle:多发伤患者凝血功能指标在病情程度和预后判断中的作用研究
- Author:
Yunguang SHI
1
;
Zhigang ZHANG
;
Ruiying ZHANG
;
Lei LIU
Author Information
1. 河北工程大学附属医院急诊科
- Keywords:
Multi-trauma;
Trauma-induced coagulopathy;
Injure severity score
- From:
Journal of Navy Medicine
2017;38(2):170-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of trauma-induced blood coagulation dysfunction in the evaluation of severity and prognosis of the patients with multi-trauma.Methods Eighty-two cases of multi-trauma patients admitted into the ICU of the department from June 2013 to January 2015 were chosen as the research subjects.The patients were divided into the trauma-induced coagulopathy (TIC) group(n =37)and the non-trauma-induced coagulopathy (NTIC) group (n =45),by depending on whether or not they had coagulopathy,and they were further divided into the death group (n =25) and the survival group(n =57),in view of prognosis 14 days after injury.Indices such as platelet (Plt),fibrinogen (FIB),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time(TT) were measured within 6 hours after admission into hospital.Injury severity scores (ISS) of the subjects were evaluated 12 hours after admission,acute physiological and chronic health evaluationⅡ (APACHE Ⅱ)were performed within 24 hours after admission.Six mouths after injury,the survivors in both the TIC group and the NTIC group had medical follow-ups,and scores of Nottingham health profile (NHP) were evaluated.Results The levels of PLt and FIB in the TIC group were lower than those in the NTIC group,and the levels of PT,APTT and TT in the TIC group were all higher than those in the NTIC group,with statistical significance (P ＜ 0.01).The scores of ISS and APACHE Ⅱ in the TIC group were all significantly higher than those in the NTIC group,also with statistical significance(P ＜0.05).Fourteen days after injury,16 cases in the TIC group died (43.24％),and in the NTIC group 9 cases died (20％).Statistical significance could be noted when comparisons were made between the 2 groups (P ＜ 0.05).Six months after injury,the NHP scores of the TIC group were (97.85 ±23.17),while those of the NTIC group were (86.24 ±20.16).Statistical significance could also be noted when comparisons were made between the 2 groups(P ＜ 0.05).The levels of PLt and FIB in the death group were all higher than those in the survival group.The scores of PT,APTT and TT in the death group were higher than those in the survival group,and the scores of ISS and APACHE Ⅱ at the time of admission in the death group were all significantly higher than those in the survival group.Statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.01).Conclusion There was a high probability for those patients with multi-trauma to have TIC.Coagulation index was of significant importance to the diagnosis and prognosis of the patients with multiple injuries.
