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目的 :探讨特重度烧伤患者凝血功能动态变化规律以及对患者预后可能的影响。方法 :选取特重度以上烧伤患者60例,根据患者治疗结局分为存活组(57例)和死亡组(3例),观察两种患者在入院15d内纤维蛋白原和D-二聚体变化情况。结果 :死亡组在住院3d、5d、9d、11d、13d,15d纤维蛋白原水平明显高于存活组,差异有统计学意义,在住院5d、9d、11d、13d,15d D-二聚体水平明显高于存活组,差异有统计学意义;存活组在入院后纤维蛋白原和D-二聚体水平开始上升,至入院5d达到最高峰后开始下降,至第15d始终处于下降状态;死亡组在入院后纤维蛋白原和D-二聚体水平同样上升,并至第5d达到最高值后开始下降,但在第9d又开始上升,至11d达到最高值开始下降,至15d一直处于下降状态。结论 :凝血功能异常严重的患者更容易出现病情恶化甚至死亡,而死亡较常集中在入院后3~5d以及9~11d。
Objective: To investigate the dynamic changes of coagulation function in patients with severe burns and the possible impact on the prognosis of patients. Methods: Sixty patients with severe burns were selected and divided into survival group (57 cases) and death group (3 cases) according to the treatment outcome. The changes of fibrinogen and D-dimer in both groups were observed 15 days after admission . Results: The levels of fibrinogen in the death group at 3, 5, 9, 11, 13 and 15 days after hospitalization were significantly higher than those in the survival group. There were significant differences in the levels of D-dimer at 5 days, 9 days, 11 days, 13 days and 15 days after hospitalization Significantly higher than the survival group, the difference was statistically significant; survival group after admission, fibrinogen and D-dimer levels began to rise to the peak 5d admission began to decline, to 15d has been in a decline; death group After admission, the levels of fibrinogen and D-dimer also increased, and began to decline after reaching the highest value on the 5th day, but began to rise again on the 9th day, reached the highest value on the 11th day, and then decreased to the 15th day. CONCLUSIONS: Patients with severe coagulation dysfunction are more likely to be exacerbated or even die, while deaths are more often concentrated 3 to 5 days and 9 to 11 days after admission.