血栓弹力图法评估凝血紊乱与儿童脓毒症严重程度及预后的相关性  

Thromboelastography to Assess the Correlation between Coagulopathy and the Severity and Prognosis of Sepsis in Children

作　　者：刘斌 刘善利 范佩佩 崔伟华 秦宇杰 LIU Bin;LIU Shan-li;FAN Pei-pei;CUI Wei-hua;QIN Yu-jie(Department of Clinical Laboratory,Changle County People's Hospital,Weifang,Shandong Province,262400 China)

机构地区：[1]昌乐县人民医院检验科,山东潍坊262400

出　　处：《系统医学》2020年第8期53-55,共3页Systems Medicine

基　　金：血栓弹力图检测儿童脓毒症凝血紊乱的临床研究(wfwsjs-2018-075)。

摘　　要：目的探讨儿童脓毒症严重程度及预后及血栓弹力图法评估凝血紊乱的相关性。方法选择该院的100例脓毒血症患儿为试验对象(2018年2月—2019年1月收治),根据脓毒血症的疾病程度分为脓毒症组(60例)、严重脓毒症组(40例),分别在入院后检测患儿的TEG结果;又依据凝血程度分为高凝组(50例)、低凝组(50例)的d1炎症指标、器官功能及危重评分。结果该文研究中,严重脓毒血症的R、K、a、MA、CL各项指标均比较脓毒血症组的各项指标差异有统计学意义(t=12.975、11.105、23.447、17.037、14.364,P<0.05);高凝组的d1的中性粒细胞计数、RCT、WBC、CRP、BUN、Cr、ALT指标对比低凝组差异有统计学意义(t=13.057、12.334、16.978、26.311、11.147、19.397、67.117,P<0.05),高凝组P-MODS评分为(1.48±0.34)分,低于低凝组的P-MODS评分为(6.78±1.66)分,差异有统计学意义(t=22.146,P<0.05)。结论当呈现低凝的TEG结果可对患儿的脓毒血症严重程度进行有效反映,TEG结果对脓毒血症的预后预测具有参考的价值。Objective To explore the correlation between sepsis severity and prognosis in children and thromboelastography to assess coagulopathy.Methods A total of 100 children with sepsis in our hospital were selected as test subjects(from February 2018 to January 2019).They were divided into sepsis groups according to the severity of sepsis(60 cases),severe sepsis group(40 cases),the TEG results of the children were detected after admission;they were further divided into coagulation group(50 cases),hypocoagulation group(50 cases),d1 inflammation index,Organ function and critical score.Results In this study,the R,K,a,MA,and CL indexes of severe sepsis were different from those of the sepsis group,and they were statistically significant(t=12.975,11.105,23.447,17.037,14.364,P<0.05);d1 neutrophil counts,RCT,WBC,CRP,BUN,Cr,and ALT in the high-coagulation group were significantly different from those in the low-coagulation group,with statistical significance difference(t=13.057,12.334,16.978,26.311,11.147,19.397,67.117,P<0.05),the P-MODS score of high-coagulation group was(1.48±0.34)points,and the P-MODS score was lower than the hypocoagulation group(6.78±1.66)points,with statistical significance difference(t=22.146,P<0.05).Conclusion When the TEG result showing hypocoagulation can effectively reflect the severity of sepsis in children,the TEG result has reference value for predicting the prognosis of sepsis.

关 键 词：脓毒症 严重程度 预后 血栓弹力图法 凝血紊乱 

分 类 号：R447[医药卫生—诊断学]