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目的探讨芦山与汶川地震所致伤员及不同救治时间伤员血浆纤维蛋白原(Fbg)水平的变化。方法选择2013年4月20日-24日入院治疗的276例芦山地震伤员和2008年5月13日-17日入院治疗的503例汶川地震伤员为研究对象,按灾后入院时间分别分为5组,检测患者血浆Fbg水平,分析血浆Fbg水平变化以及不同入院时间的患者血浆Fbg水平变化,分别对芦山地震和汶川地震各组间Fbg水平进行两两比较;将91例芦山地震骨折伤员和130例汶川地震骨折伤员分为肢体多处骨折组和肢体单处骨折组,分层分析两次地震Fbg水平的差异。结果芦山地震伤员的Fbg整体水平[(2.70±1.15)g/L]低于汶川地震伤员[(4.47±1.94)g/L],相同入院时间芦山地震伤员Fbg水平均低于汶川地震伤员,差异有统计学意义(P<0.01);地震后48 h以内入院的伤员Fbg水平与48 h以后入院的伤员Fbg水平差异有统计学意义(P<0.01);芦山地震中肢体多处骨折伤员与肢体单处骨折伤员Fbg水平[分别为(2.21±0.76)、(1.98±0.85)g/L]均低于汶川地震[分别为(3.35±1.48)、(3.11±1.05)g/L],差异有统计学意义(P<0.01)。结论在突发事件等引起的急性应激损伤中患者血浆Fbg水平有不同程度的变化,不同入院时间患者Fbg水平的变化也有所差异,应针对此采取相应防治措施。
Objective To investigate the changes of plasma fibrinogen (Fbg) level in wounded and injured wounded people in Lushan and Wenchuan Earthquakes. Methods A total of 503 cases of wounded people in Wenchuan Earthquake hospitalized during 276 cases of Lushan earthquake who were admitted to hospital from April 20 to April 24, 2013 and from May 13 to May 17, 2008 were selected and divided into 5 groups , Detect the level of Fbg in plasma, analyze the change of plasma Fbg level and the level of Fbg in plasma at different time of admission, compare the level of Fbg in each group of Lushan earthquake and Wenchuan earthquake, compare 91 cases of fracture of Lushan earthquake and 130 cases Wounds in the Wenchuan earthquake were divided into multiple fractures of the limbs and single fractures of the limbs. The Fbg levels of the two earthquakes were analyzed by stratification. Results The overall level of Fbg in the Lushan earthquake was lower than that of the Wenchuan earthquake [(2.70 ± 1.15) g / L] [(4.47 ± 1.94) g / L] (P <0.01). There was a significant difference in the Fbg level between the wounded hospitalized within 48 hours after earthquake and the hospitalized wounded 48 h after the earthquake (P <0.01) The level of Fbg was significantly lower in patients with single fracture (2.21 ± 0.76, 1.98 ± 0.85, g / L, respectively) than those in Wenchuan earthquake (3.35 ± 1.48, 3.11 ± 1.05 g / L, Statistical significance (P <0.01). Conclusions The level of plasma Fbg in patients with acute stress injury caused by unexpected events varies in varying degrees. The changes of Fbg levels in different hospitalized patients are also different. Corresponding prevention and control measures should be taken accordingly.