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目的研究凝血功能四项检测在评估ICU重症休克患者预后中的价值。方法以2014年3月~2016年3月ICU收治的125例重症休克患者为研究对象,依据28 d预后情况将患者分为存活组(95例)与死亡组(30例),比较分析两组患者APACHEII评分、凝血四项检测、乳酸水平等相关资料,并通过Logistic多因素回归分析影响重症休克患者预后(死亡)的独立危险因素。结果存活组患者APACHEII评分、乳酸水平、PT、Fbg、D-D水平分别为(23.35±3.08)分、(2.18±2.40)mmol/L、(13.05±1.80)s、(3.59±1.72)g/L、(4.90±10.10)mg/L,较死亡组的(28.35±7.12)分、(4.58±4.47)mmol/L、(16.14±1.50)s、(2.80±1.75)g/L、(10.88±17.26)mg/L差异有统计学意义(P<0.05)。Logistic回归分析显示ICU重症休克患者预后独立危险因素为APACHEII评分、乳酸水平、D-D水平。结论凝血功能四项检测对ICU重症休克患者预后评估有一定的价值,同时乳酸水平、D-D水平可作为重症休克患者死亡独立危险因素。
Objective To investigate the value of four coagulation tests in evaluating the prognosis of ICU patients with severe shock. Methods 125 patients with severe shock admitted to ICU from March 2014 to March 2016 were enrolled in this study. Patients were divided into survival group (n = 95) and death group (n = 30) according to the prognosis of 28 days. APACHEII score, coagulation test, lactate level and other related data. Logistic regression analysis was used to analyze the independent risk factors influencing prognosis (death) in patients with severe shock. Results The APACHEII score, lactate level, PT, Fbg and DD levels were (23.35 ± 3.08), (2.18 ± 2.40) mmol / L and (13.05 ± 1.80) s and (3.59 ± 1.72) g / (4.90 ± 10.10) mg / L and (28.35 ± 7.12), (4.58 ± 4.47) mmol / L and (2.80 ± 1.75) g / L and (10.88 ± 17.26) mg / L difference was statistically significant (P <0.05). Logistic regression analysis showed that the independent prognostic risk factors of severe ICU patients were APACHEII score, lactate level and D-D level. Conclusion The four tests of coagulation function have certain value in the prognosis evaluation of ICU patients with severe shock, and the levels of lactate and D-D can be used as independent risk factors of death in patients with severe shock.