创伤性多发伤的预后与肝功能的关系  

The relationship between prognosis and liver function of trauma multiple injury

作　　者：甘宜超[1] 蔡文伟[1] 许秋然[1] 蒋成行[1] 

机构地区：[1]浙江省人民医院急诊科,浙江杭州310000

出　　处：《中国现代医生》2016年第27期25-28,共4页China Modern Doctor

基　　金：浙江省自然科学基金(LY16H160043)

摘　　要：目的探讨创伤性多发伤的预后与肝功能的关系。方法 选取我院2010年10月~2016年6月的64例创伤性多发伤患者进行分析,其中死亡46例,存活18例,对患者的α-L-岩藻糖苷酶（AFU）、白蛋白（ALB）、碱性磷酸酶（ALP）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、直接胆红素（DBIL）、谷氨酰转肽酶（GGT）、球蛋白（GLB）、间接胆红素（IBIL）、总胆汁酸（TBA）、总胆红素（TBIL）、总蛋白（TP）等指标进行测定,分析创伤性多发伤的死亡、存活与肝功能的关系。结果 死亡患者的AFU、ALB、TBA、GLB、TP水平与存活患者比较差异无统计学意义（P〉0.05）;死亡患者的ALT、AST、DBIL、IBIL、TBIL、GGT水平均明显高于存活患者,差异有统计学意义（P〈0.05）;死亡患者的ALP水平明显低于存活患者,差异有统计学意义（P〈0.05）;对死亡患者与存活患者的ALT、AST、DBIL、IBIL、TBIL、GGT、ALP存在明显差异的指标进行多因素分析,结果显示DBIL、IBIL、TBIL与创伤性多发伤的预后有密切关系（P〈0.05）。结论 创伤性多发伤患者的死亡或存活与ALT、AST、DBIL、IBIL、TBIL、GGT、ALP等肝功能水平有关,DBIL、IBIL、TBIL是独立危险因素。Objective To study the relationship between the prognosis and liver function in patients with trauma multiple injury. Methods From October 2010 to June 2016, 64 cases of traumatic multiple trauma patients were analyzed, of which 46 cases died and 18 cases survived. The patient＇s alpha L fueosidase（AFU）, albumin（ALB）, alkaline phosphatase （ALP）, alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, direct bilirubin （DBIL）, valley aminoacyl transfer peptidase （GGT）, globulin （GLB）, indirect bilirubin （IBIL）, total bile acid （TBA）, total bilirubin （TBIL）, total protein （TP） and other indicators were measured, relationship between traumatic injury death, survival and liver function were analyzed. Results AFU, ALB, TBA, GLB, TP levels of died patients and patients survival had no significant difference （P〉0.05）; the ALT, AST, DBIL, IBIL, TBIL, GGT levels of death of patients were significantly higher than the surviving patients, with statistical significance（P〈0.05）; ALP levels of death patients were significantly lower than the survival of patients, with significant difference（P〈0.05）. The dead patients and survival in patients with ALT, AST, DBIL and IBIL, TBIL, GGT, ALP existed obvious difference index were used for multivariate analysis. The results showed that DBIL and IBIL, TBIL related to the traumatic multiple injuries prognosis（P〈0.05）. Conclusion The death or survival of patients with traumatic multiple injuries is related to the levels of ALT, AST, DBIL, IBIL, TBIL, GGT, ALP and other liver function, DBIL, IBIL, TBIL are independent risk factors.

关 键 词：创伤性多发伤 总胆红素 直接胆红素 间接胆红素 肝功能 

分 类 号：R641[医药卫生—外科学] R575.3[医药卫生—临床医学]