脓毒症及严重脓毒症患儿凝血功能变化探究.docVIP

脓毒症及严重脓毒症患儿凝血功能变化探究 目的：探讨脓毒症患者血D-二聚体水平及凝血功能 数据变化的比较研究。方法：选择脓毒症及严重脓毒症患者 各20例，观察两组患者治疗前、后及两组之间，凝血酶原 时间（PT）、凝血酶原国际标准化比（PT-INR）、活化部分凝 血活酶时间（APH）、凝血酶时间（17）、纤维蛋白原（FIB）、 D-二聚体（D-dimer，D-D）数量变化。采用SPSS 13. 0统计 分析软件进行处理。结果：两组患者急性期除FIB无明显变 化外，其余各项指标均明显延长。脓毒症组治疗前后凝血酶 原时间，凝血酶国际标准化比值明显下降，有统计学意义（P 0. 05）,其他无显著变化；严重脓毒症组治疗前、后除纤 维蛋白原外，其他数据明显下降，有统计学意义（P0. 05）, 而两组之间无统计学差异。结论：脓毒症存在凝血功能障碍， 和病情严重程度有关。 关键词脓毒症凝血酶原时间活化部分凝血活酶时间 D —二聚体纤维蛋白原 AbstractObjective：to explore the changes of coagulation function in the patients with sepsis of postoperative. Methods：40 patients were divided into 2 groups：sepsis group and severe sepsis group according to the criteria for the selection of sepsis, the sepsis group included 20 patients and severe sepsis group included 20 patients. Results： levels of prothrobin time (pt)，internation prothrobin time pt_INR thrombin time (tt ) ， activated partial thomboplastin time (aptt) ,fibrinogen (fbg) and d-dimer (dd) were measured in all the patients. Result：levels of pt, tt，aptt and dd were higher in sepsis group and severe sepsis group but fibrinogen ( fbg ) . levels of pt, apt,tt,and D-D in severe sepsis during acute stage were higer during Convalescence stage (P0. 05) . in sepsis group, pt was prolonged, level of pt in sepsis was higer than in severe sepsis (P0. 05) , but apt, tt, fbg and dd were not different between in sepsis and severe sepsis. Conclusions：there are dysfunctions of coagulation function in the patients with sepsis.the patients’ coagulation function are associated with the prognosis and severity of sepsis. Key wordsseps i s；PT；APTT；DD；FBG 脓毒症(Sepsis)是严重创(烧)伤、休克、感染、外 科大手术后常见的并发症［1］，是由于感染而导致的全身性 炎症反应综合征(systemic inflammation response syndrome, SIRS)的临床表现。如果脓毒症早期持续的SIRS 得不到有效的控制，进一步发展可导致脓毒性休克、多器官 功能障石辱绿合征(multiple organ dysfunction syndrome MODS)，而MODS的进一步发展为多脏器功能衰竭(multiple organ failure, MOF), MOF是临床危重患者的最主要死亡原 因之一；而凝血功能异常在脓毒症发生发展过程中具有重要 作用［2］。脓毒症时机体炎症细胞过度激活，产生并释放大 量细胞因子，这些过度释放的细胞因子通过各种途径激活凝 血系统，使机体处于高凝状态，随即机体产生抗凝物质和启 动纤维蛋白溶解系统。凝血系统活化，促进炎症进一步恶化， 两