严重创伤后患者继发性血小板增多症的临床分析  

A clinical analysis of severe trauma patients with secondary thrombocytosis

作　　者：庾胜 YU Sheng(Department of Intensive Care Unit,Changshu Second People's Hospital in Jiangsu Province,Suzhou 215500,China)

机构地区：[1]常熟市第二人民医院重症医学科,江苏苏州215500

出　　处：《中国处方药》2023年第1期160-163,共4页Journal of China Prescription Drug

摘　　要：目的探究严重创伤后患者继发性血小板增多症的发病特征及对预后的影响。方法回顾性分析江苏省常熟市第二人民医院重症医学科2017年9月~2019年9月严重创伤患者继发性血小板增多症的发生率,人群分布及时间分布特点,并探究其与血栓栓塞事件、患者死亡率等临床事件的关系。结果共纳入严重创伤患者127例,继发性血小板增多症发生率为18.1%。继发性血小板增多症组与血小板正常组患者APACHEⅡ评分、ISS评分及损伤部位差异均无统计学意义(P>0.05)。但血小板增多症组患者使用过促血小板生成素的比例显著高于血小板正常组(30.4%vs.0.96%,P<0.01)。血小板增多症组最高血小板计数显著高于血小板正常组[(740.3±211.5)×10^(9)/L vs.(273.4±132)×10^(9)/L,P<0.01],但血小板高峰出现时间晚于血小板正常组(18.3±12.7 d vs.6.4±4.7 d,P<0.01)。血小板最高值出现的频数如下:(450~600)×10^(9)/L 6例;(600~750)×10^(9)/L 7例;(750~900)×10^(9)/L 6例;(900~1050)×10^(9)/L 2例;(1050~1300)×10^(9)/L 1例;(1300~1450)×10^(9)/L 0例;(1450~1600)×10^(9)/L 1例;>1600×10^(9)/L 0例。血小板增多症组和血小板正常组死亡率分别为17.4%vs.13.5%(P=0.62)。两组总住院时间、ICU住院时间差异无统计学意义(P均>0.05)。与血小板正常组相比,血小板增多症并未增加动脉血栓栓塞事件、静脉血栓栓塞事件、DVT/PTE事件的发生率(P>0.05)。结论创伤后患者继发性血小板增多症患者并不少见,其血小板最高值出现时间晚于血小板正常者,主要分布在(450~900)×10^(9)/L。与血小板正常组相比,继发性血小板增多并未增加患者血栓栓塞性疾病发病率、住院时间及死亡率。Objective To explore the characteristics and prognosis of secondary thrombocytosis patients with severe trauma.Methods A retrospective study was conducted in severe trauma patients who admitted to intensive care unit of Changshu Second People’s Hospital during September 2017 to September 2019.This study was to analyze the incidence of secondary thrombocytosis,the distribution characteristics of thrombocytosis,and the relationship between the secondary thrombocytosis and incidence of thromboembolism events,mortality,and other clinical events.Results A total of 127 patients with severe trauma were included,and the incidence of secondary thrombocytosis was 18.1%.There were no significant differences in APACHEⅡscores,ISS scores,and injury sites between patients with secondary thrombocytosis and those with normal platelet count(P>0.05).The percentage of thrombopoietin used in thrombocytosis group was significantly higher than that in the normal platelet count group(30.4%vs.0.96%,P<0.01).The highest platelet count in the thrombocytosis group was significantly higher than that in the normal platelet count group[(740.3±211.5)×10^(9)/L vs.(273.4±132)×10^(9)/L,P<0.01],but the peak of platelet count in patients with thrombocytosis comes later than patients with normal platelet count(18.3±12.7 d vs.6.4±4.7 d,P<0.01).The distribution characteristics of the highest platelet counts were as follows:6 cases were distributed in the interval of(450~600)×10^(9)/L;7 cases were distributed in the interval of(600~750)×10^(9)/L;6 cases were distributed in the interval of(750~900)×10^(9)/L;2 cases were distributed in the interval of(900~1,050)×10^(9)/L;1 case was distributed in the interval of(1,050~1,300)×10^(9)/L;0 case was distributed in the interval of(1,300~1,450)×10^(9)/L;1 case was distributed in the interval of(1,450~1,600)×10^(9)/L;0 case was distributed in the interval of>1,600×10^(9)/L.The mortality rates forpatients with thrombocytosis and patients with normal platelet count were 17.4%vs.13.5%(P=0.62),respec

关 键 词：严重创伤 继发性血小板增多症 预后 

分 类 号：R558.3[医药卫生—血液循环系统疾病]