重度脓毒症患者凝血功能四项检测的临床意义

目的探讨重度脓毒症患者凝血功能四项检测的临床意义。方法选取我院2014年1月至2016年1月期间收治的脓毒症患者78例,根据病情严重程度分为轻中度组40例、重度组38例,其中重度组根据预后情况分为存活组22例和死亡组16例。检测所有患者凝血功能四项指标凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)及纤维蛋白原(Fbg),比较轻中度组、重度组脓毒症患者凝血功能四项指标水平及急性生理和慢性健康评分(APACHE II)与病死率,同时比较重度患者存活组、死亡组脓毒症患者凝血功能四项指标水平。结果重度组PT、aPTT、TT(均明显较轻中度组长(P0.05),Fbg(较轻中度组低(P0.01)。重度组APACHE II评分显著高于轻中度组(P0.01);重度组病死率42.11%显著高于轻中度组5.00%(P0.01)。死亡组PT、aPTT、TT均明显较存活组长(P0.05),Fbg较存活组低(P0.05)。结论重度脓毒症患者凝血功能与轻、中度患者相比存在显著差异,重度患者死亡与存活亦存在明显差异,故四项凝血功能指标对重度脓毒症的诊断与预后评估具有重要的参考价值。

Clinical Significance of Detection of four Coagulation Function in Patients with Severe Sepsis

Objective To study on clinical significance of detection of four coagulation function in patients with severe sepsis.Methods 78 patients with sepsis treated in our hospital from January 2014 to January 2016 were selected,they were divided into mild to moderate group (40 cases)and severe group (38 cases) according to the severity of disease,severe group was divided into survival group (22 cases) and death group (16 cases)according to the prognosis.Four coagulation function indexes thrombin time (TT),prothrombin time (PT),activated partial thromboplastin time (aPTT) and fibrinogen (Fbg) of patients were detected,four coagulation function indexes level,acute physiology and chronic health score (APACHE Ⅱ),case fatality rate in mild to moderate group and moderate group were compared,four coagulation function indexes level in severe patients of survival group and death group were compared.Results PT、aPTT,TT in severe group were significantly longer than mild to moderate group (P ＜ 0.05),Fbg was significantly lower than mild to moderate group (P ＜ 0.01).APACHE Ⅱ score in severe group was significantly higher than mild to moderate group (P ＜ 0.01);case fatality rate in severe group 42.11％ was significantly higher than mild to moderate group(5.00％)(P ＜0.01).PT、aPTT,TT in death group were significantly longer than survival group (P ＜ 0.05),Fbg was significantly lower than survival group (P ＜ 0.05).Conclusion Coagulation function TF、PT、aPTT,Fbg four indexes of patients with severe sepsis have significant differences from mild to moderate patients,in severe patients prognosis death and survival have significant differences.TT,PT,aPTT,Fbg four coagulation function indexes have an important clinical significance in the diagnosis and prognosis evaluation of severe sepsis.