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1、急性创伤性血胸凝血功能异常的临床研究作者：王良馥，陈自力,熊建生，黄强，毛洪涛单位：解放军第94医院ICU,江西南昌330002【摘要】目的探讨急性创伤性血胸患者的凝血功能变化特点及与出血量严重程度、预后的关系。方法①将126例急性创伤性血胸患者分为小量、中量、大量3组,测定患者入院当时、24h、及72h的血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板(BPC)值，并与43例健康对照组比较。②入院、24h、72h将齐纽血胸的凝血指标异常发生情况进行比较。结果①各型血胸中入院吋PT、APTT
2、、FIB、BPC均有异常，随着胸腔出血量増大，PT、APTT均升高，FIB、BPC降低。②入院24h各纽血胸的凝血指标异制发生率无明显差异。③入院72h大量血胸纽.患者的凝血指标异常发生率和中、小量血胸纽•相比有明显差界。结论小量血胸患者的凝血功能无异帘改变，中、大量血胸患者的凝血功能异常，口与血胸量程度相关,大杲血胸组患者的入院72h凝血指标异常发生率显箸提高，可为急性创伤性血胸的治疗和判断预后提供依据。【关键词】血胸;凝血功能严重程度;预后Clinicalstudyofbloodcoagulationandfibrinolys
3、ininacutetraumatichemothoraxWANGLiangfu,CHENZili,XIONGJiansheng,HUANGQiang,MAOHongtao(DepmlmentofICU,the94thHospitalofPLA,Nanchang330002,Jiangxi,China)[Abstract]ObjectiveToinvestigatethecharacteristicsofbloodcoagulationandfibrinolysininacutetraumatichemothoraxandtoeva
4、luateitsrelationshipwithbleedingvolumeandprognosis.Methods①Divided126casesintothreegroups:alittleamount,mediumamountandthelargeamount,accordingtothebleedingvolumeofacutetraumatichemothorax.Detectedthelevelsofplasmaprothrombintime(PT),activepartplasmaprothrombin(APTT),
5、Fibrinogen(FIB),andthrombocyte(BPC)atpatientsregisteredthehospital,after24hoursand72hoursrespectively,andcomparedwiththehealthycontrolgroup.②Comparedtheabnormallevelofthecoagulantindexbetween24hoursand72hoursgroup.Results①PT,APTT,FIBandBPCwereabnonnalinallkindsofacute
6、traumatichemothorax,whenthepatientsregisteredthehospital.Morebleedingvoulum,higherlevelofPTandAPTTwerefound,butreverseofthelevelofFIBandBPC.②Patientsenrolledinthe24hoursgrouphadnosignificantdifferenceintherateoftheabnormalcoagulationparameters.③Thereweregreatchangesbe
7、tweenthelargeamountandtheothergroups.ConclusionTherewereobviouschangesofPT,APTT,FIBandBPCinthegroupsofmediumandlargeamountbleeding,exceptthelittleamountgroup,andthechangeswererelatedtothevolumeofbleeding.Forthecoagulationparameterswaselevatedsignificantlyinthepatients
8、withlargeamounthemothorax(after72hours),PT,APTT,FIBandBPCcouldbegoodindexestojudgetheprognosisofpatientssufferedfromacutetra
