创伤患者早期离子钙测定的临床意义.doc

PAGE PAGE 6 创伤患者早期离子钙测定的临床意义 【摘要】：目的 观察创伤患者早期离子钙水平的变化及临床意义。方法 选择收入ICU中的创伤患者94例，在入院时即行离子钙测定及创伤严重度评分（ISS评分），并取入院24小时内最差的生理参数及实验室检查结果进行APACHE = 2 \* ROMAN II评分，按ISS分值、APACHE = 2 \* ROMAN II分值及预后分组。结果 离子钙水平随着ISS、 APACHE = 2 \* ROMAN II分值的增高而降低，各分值组间比较有显著性差异（F=72.361，F=117.227，P＜0.01）;创伤患者死亡组离子钙水平明显低于存活组、ISS评分及APACHE = 2 \* ROMAN II评分显著高于存活组（t=6.955、t=8.524、t=10.358，P＜0.01）; 离子钙、ISS评分及APACHE = 2 \* ROMAN II评分三者呈显著正相关（r=-0.848、r=-0.802、r=0.875, P＜0.01）。结论 创伤患者早期离子钙水平与创伤严重程度及预后有显著关系，其水平对临床评估创伤患者严重程度及预后有一定的意义。 【关键词】：创伤；离子钙；损（创）伤严重度评分；APACHEⅡ评分 【中图分类号】R641 【文献标识码】A The clinical significance of determining initial ionized calcium in trauma patients. 【Abstract】: Objective To observe the changes and clinical significance of initial ionized calcium in trauma patients. Methods Injury serious score(ISS) was determined for 94 trauma patients after adminssion,at the same time,the levels of ionized calcium were measured. A severity of illness score (APACHEⅡ) was determined for 94 trauma patients during the first 24h in the hospital.All the patients were divided into two or three groups based on ISS、APACHEⅡ and prognosis. Results With ISS and APACHEⅡ score increasing,the levels of ionized calcium decreased,and ionized calcium between the groups had significantly difference(F=72.361,F=117.227,P＜0.01);the death group of ionized calcium was significantly lower than the survial group(t=6.955,P＜0.01),and the death group of ISS、APACHEⅡ score were significantly higher than the survial group(t=8.524, P＜0.01;t=10.358, P＜0.01).There were significantly positive correlation between the levels of ionized calcium 、ISS and APACHEⅡ score（r=-0.848、r=-0.802、r=0.875, P＜0.01）. Conlusion There is significantly positive correlation between the initial ionized calcium and the severity of injury and prognosis,and the levels of ionized calcium play important role in estimation of development and prognosis of trauma. 【Key Words】:Trauma; Ionized calcium;ISS score;APACHEⅡ score 近年来，创伤已成为临床急危重症患者死亡的主要