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性重症患者的COVID-19相关凝血病 - 一个回顾性队列研究
Mirza Kovačević1,2, Nermina Rizvanović1,2, Adisa Šabanović Adilović1,2
1Department of Anaesthesiology, Resuscitation and Intensive Care, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
概括
患有败血症或败血症休克的COVID-19危急病患者经常表现出凝血障碍. 这些异常表明败血症诱导的凝血病,这表明两种情况的综合管理方法.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- COVID-19急性缺血性呼吸衰竭 (CAHRF) 可能导致败血症和败血性休克.
- 凝血障碍是严重感染的重症患者的一个重要问题.
研究的目的:
- 为了研究凝血障碍与严重病患COVID-19患者的败血症和败血症休克的发展之间的关系.
- 在这个人群中识别与败血症和败血症休克相关的特定凝血异常.
主要方法:
- 对99名危急COVID-19患者的回顾性分析.
- 患者被分为败血症和败血性休克组.
- 记录了关键的临床和实验室参数,包括凝血标志物 (纤维素,D-二次体,INR,SIC评分),炎症标志物 (PCT,CRP) 和器官衰竭评分 (qSOFA).
主要成果:
- 败血症诱导的凝血病 (SIC) 评分在败血症和败血症休克组中都具有统计学意义.
- 国际正常化比率 (INR),前素 (PCT) 和淋巴细胞计数在败血症休克组显著增加.
- 血管抑制剂的使用 (诺拉上腺素,多布他胺) 和qSOFA得分与败血症和败血性休克显著相关.
结论:
- 患有败血症/败血休克的重症COVID-19患者的凝血异常符合SIC的标准.
- 凝血障碍的管理应与这些患者的败血症管理相结合.
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