术前血小板计数对重度烧伤Meek植皮术后皮片存活情况的预测价值  

Predictive Value of Preoperative Platelet Count for Skin Graft Survival after Meek Skin Grafting in Severe Burn Patients

作　　者：李晓静[1] 张燊璐 马亚军[3] LI Xiao-jing;ZHANG Shen-lu;MA Ya-jun(Department of Blood Transfusion,Yan'an People's Hospital,Shaanxi Yan'an 716000)

机构地区：[1]延安市人民医院输血科检验科,陕西延安716000 [2]延安市人民医院检验科,陕西延安716000 [3]陕西省汉中市中心医院烧伤科,陕西汉中723000

出　　处：《医学临床研究》2021年第12期1818-1821,共4页Journal of Clinical Research

摘　　要：【目的】探讨术前血小板计数对重度烧伤Meek植皮术后皮片存活情况的预测价值。【方法】本院80例行Meek植皮术的重度烧伤患者,根据术后14 d皮片存活情况将患者分为皮片存活良好组(A组,57例,皮片存活率≥70%)、皮片存活不良组(B组,23例,皮片存活率<70%)。比较两组患者一般情况、Ⅲ度烧伤面积、烧伤指数、合并吸入性损伤情况及术前半胱氨酸蛋白酶抑制剂C、白蛋白、中性粒细胞、血红蛋白、C反应蛋白、血清降钙素原、收缩压、舒张压、术前血小板计数水平。采用多因素Logistic回归分析影响患者术后皮片存活不良的危险因素,绘制受试者工作特征曲线(ROC)曲线分析术前血小板计数对术后皮片存活不良的诊断效能。【结果】与A组比较,B组患者Ⅲ度烧伤面积、烧伤指数均较高,术前血小板计数水平降低(均P<0.05)。多因素Logistic回归分析显示,术前血小板计数水平低是重度烧伤患者Meek植皮术后皮片存活不良的独立危险因素(OR=5.010,P<0.05);术前血小板计数预测患者术后皮片存活不良的AUC为0.826(95%CI:0.793~0.867),截断值为126.78×10^(12)/L,灵敏度为85.33%,特异度为70.62%。【结论】术前血小板计数低是影响重度烧伤Meek植皮术后皮片存活的独立危险因素,对术后皮片存活情况具有一定预测价值,可为临床预测术后皮片存活情况以确定最佳手术时机提供一定参考。【Objective】To explore the predictive value of preoperative platelet count for skin graft survival after Meek skin grafting in severe burn patients.【Methods】A total of 80 patients with severe burns who underwent Meek skin grafting were enrolled in this study.Patients were divided into two groups according to the survival of skin grafts 14 days after surgery.There were 57 patients in the skin survival good group(skin graft survival rate≥70%)and 23 patients in the skin survival poor group(skin graft survival rate<70%).General condition,third-degree burn area,burn index,combined inhalation injury,preoperative cystatin C,albumin,neutrophil,hemoglobin,C-reactive protein,procalcitonin,systolic blood pressure,diastolic blood pressure,and platelet count were collected.Multiple Logistic regression analysis was used to analyze the risk factors of skin graft survival.ROC curve was used to analyze the diagnostic efficacy of preoperative platelet count in patients with skin graft survival.【Results】Compared to the group with good skin graft survival,the third-degree burn area and burn index in the skin graft poor survival group were higher,while the preoperative platelet count was lower(P<0.05).Multivariate Logistic regression analysis showed that low platelet count was an independent risk factor for poor skin graft survival in Meek patients after skin grafting(OR=5.010,P<0.05).The AUC and truncation value for preoperative platelet count to predict the survival rate of grafting skins were 0.826(95%CI:0.793~0.867)and 126.78×10^(12)/L,respectively.The sensitivity was 85.33%and specificity was 70.62%.【Conclusion】Preoperative platelet count is an independent risk factor for skin graft survival after Meek skin grafting in severe burn patients.It has a certain predictive value for skin graft survival after Meek skin grafting and can be used to predict the survival of the skin graft and determine the optimal operation time.

关 键 词：烧伤/治疗 皮肤移植 血小板计数 

分 类 号：R644[医药卫生—外科学]