超越创伤诱导的凝血病:检测自发肝素化作为内皮病变的标志物,使用旋转血栓等度仪
Alexandru Emil Băetu1,2, Liliana Mirea1,3, Cristian Cobilinschi1,3
1Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Journal of clinical medicine
|July 27, 2024
概括
在创伤患者中,在12.9%的病例中发现了自身化. 血清乳酸和血管压缩剂的使用影响了凝血失调,突出了个体的创伤反应.
科学领域:
- 创伤和紧急医疗医学
- 凝血和血液静止作用
- 关键的护理关键的护理
背景情况:
- 创伤引起的凝血病 (TIC) 是复杂的,涉及患者,创伤和复苏因素.
- 内脏病变,以内脏功能障碍,异常凝血和炎症为特征,是严重创伤和出血性休克的标志.
- 最佳的创伤复苏旨在促进修复和预防二次伤害.
研究的目的:
- 为了调查多重创伤患者自身化发生率.
- 确定影响创伤患者凝血失调的因素.
主要方法:
- 对217名符合柏林标准的多重创伤患者的回顾性分析.
- 根据临床和实验室数据,识别可疑有自身化病的患者.
- 使用INTEM/HEPTEM通道进行旋转性血栓形成仪 (ROTEM) 来评估凝块形成时间 (CT) 比率.
主要成果:
- 在那些临床怀疑的患者中,在28名患者 (12.9%) 确认了自身化.
- 多重线性回归表明,血清乳酸和诺亚丁上腺素的需求影响了CT (INTEM/HEPTEM) 比率.
- 平均年龄为43.43±15.45岁,平均伤害严重性得分 (ISS) 为36.98±1.875.
结论:
- 一部分创伤患者表现出受血清乳酸和血管压缩剂使用影响的自身肝素化.
- 在创伤患者中,冲击,低输液和凝血失调是相互关联的.
- 个体患者对创伤的反应显著影响凝血病.
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