早期凝血变化作为严重烧伤和吸入伤害患者不良结果的预测因素
Shengyu Huang1, Dan Wang2, Qimin Ma3
1Medical Center of Burn plastic and wound repair, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China.
Burns : journal of the International Society for Burn Injuries
|January 15, 2025
概括
早期凝血测试,如激活的部分血栓形成时间 (APTT) 和D-二次体,可以预测严重烧伤和吸入伤害患者的不良结果. 早期识别高风险凝血病,可以进行有针对性的干预.
科学领域:
- 创伤和紧急医疗医学
- 血液学 血液学 血液学
- 关键的护理关键的护理
背景情况:
- 严重的烧伤和吸入伤害可以引发早期凝血途径障碍.
- 几种早期凝血指数与这些患者的不良结果有关.
研究的目的:
- 确定具有预测价值的早期凝血指数,用于严重烧伤和吸入伤害患者的不良结果.
- 为了确定这些指数的最佳截止值.
主要方法:
- 对来自中国12个中心的433名患者进行了回顾性分析.
- 后勤回归和Youden指数被用来确定预测凝血指数和最佳切断值.
- 分析的重点是预测四个主要的28天不良结果:死亡,抗凝血,机械呼吸和持续的置换疗法.
主要成果:
- 激活的部分血栓形成时间 (APTT) 和D-二次体被确定为各种不良结果的显著风险因素.
- APTT预测了死亡,抗凝血和持续的置换疗法.
- D-二次体预测死亡和机械通风.
- 高风险凝血病,由APTT和D-二次元切断界限定义,是死亡的独立预测因素.
- 年龄,TBSA,乳糖和医院前输液量影响了高风险凝血病.
结论:
- 住院后早期的APTT和D-二次体水平有效预测严重烧伤和吸入伤害患者的不良结果.
- 这些指数有助于早期查高风险凝血病.
- 基于早期风险分层,可以实施有针对性的干预措施.
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