低体温对严重创伤患者凝血功能及预后的影响研究-东南大学学报医学版

低体温对严重创伤患者凝血功能及预后的影响研究

单位：上海市浦东医院急救创伤部, 上海 201399

分类号：R64

出版年·卷·期（页码）：2014·33·第五期（616-618）

摘要：

目的：探讨低体温对严重创伤患者凝血功能及预后的影响，为创伤患者的治疗提供参考。方法：选择严重创伤患者68例，根据入院第1个24h内的体温分为正常体温组（36~38℃）和低体温组（<36℃），比较两组的凝血功能指标及预后情况。结果：低体温组APTT、PT、TT较正常体温组明显延长，Fib、PLT明显减少，D-D明显增加，差异有统计学意义（P<0.05）。低体温组ISS评分、感染率、DIC及死亡率明显高于正常体温组，差异有统计学意义（P<0.05）。结论：严重创伤患者易发生低体温，低体温对机体凝血功能及预后均可产生不良影响。因此，积极监测体温变化并采取有效保温措施，对降低患者死亡率、改善预后有着重要意义。

Objective: To investigate the effect on coagulation function and prognosis of patient with severe trauma because of low temperature, and to provide reference for treatment of trauma patients. Methods: Sixty-eight cases of patients with severe trauma were divided into normal temperature group (36-38℃) and low temperature group (<36℃) according to the temperature in the first 24h at being hospitalized. The coagulation indexes and prognosis were compared between two groups.Results: APTT, PT, TT in low temperature group were longer obviously than those in normal temperature group.the Fib, PLT decreased significantly, the D-D increased significantly, the differences were statistically significant (P<0.05). The ISS score, infection rate, DIC incidence and mortality in low temperature group were significantly higher than those in normal group, the differences were statistically significant (P<0.05). Conclusion: Patients with severe trauma are prone to low temperature,low temperature may produce adverse effects on coagulation function and prognosis, therefore, positively monitoring the temperature changes, taking effective insulation measures has great significance to reduce patients' mortality and improve their prognosis.

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