摘要
目的探讨血浆TM、AT-Ⅲ检测在大面积烧伤削痂术后凝血功能监测中的临床应用价值。方法选择2014年2月至2016年2月本院ICU收治的大面积烧伤并有削痂手术指征的患者35例,其中早期削痂组19例,非早期削痂组16例,并选取同期本院体检中心健康体检者20例作为对照组,检测三组TM和AT-Ⅲ水平。结果早期削痂组休克期尿量高于非早期削痂组,而回收期心率和创面愈合时间均显著低于非早期削痂组(P<0.01)。早期削痂组和非早期削痂组的TM水平分别较对照组明显上调,而AT-Ⅲ水平明显下调,非早期削痂组的TM水平高于早期削痂组,AT-Ⅲ水平则低于后者(P<0.01)。烧伤病变发展与血浆TM和AT-Ⅲ水平具有相关性,且TM水平及AT-Ⅲ水平均与休克期尿量、回收期心率和创面愈合时间有明显相关性(P<0.01)。结论大面积烧伤时,由于组织和血管内皮的大面积损伤导致血液的高凝状态,焦痂早期切除可以在很大程度上控制病情发展,预防或缓解血栓形成。
Objective To investigate the Clinical application of plasma TM and AT-Ⅲ detection in monitoring coagulation function after large area burns escharectomy. Methods Thirty-five cases of patients with large area burn were selected and divided into early eschareetomy group （n=19） and non-early eschareetomy group （n=16）, and 20 cases of health in the same period of the hospital physical examination center were selected as the control group, the levels of TM and AT-Ⅲ in plasma of the three groups were detected. Results The urine output of shock period of eary escharectomy group was higher than non-early escharectomy group, and the heart rate during recory and wound healing time of eary escharectomy group were significantly lower than those of non-ealy escharectomy group （P〈0.01）. The levels of TM in the early escharectomy group and the non-early escharectomy group were higher than those of the control group, and that in the non-early escharectomy group was higher than the early escharectomy group, the levels of AT-Ⅲ were lower than those of the control group, and that in the non-early eseharectomy group was lower than the early escharectomy group （P〈 0.01）. There was a significant correlation in TM level, AT-Ⅲ level and plasma levels, the levels of TM and AT-III with urine output of shock period, heart rate during recovery and wound healing time （P〈0.01）. Conclusion When the lage area bums happened, the blood hypercoagulable state occured due the to damage of tissue and vascular endothelial, early removal of eschar can be a large extent to control the disease development, prevention or mitigation of thrombosis.
出处
《临床医学研究与实践》
2017年第12期73-74,共2页
Clinical Research and Practice
关键词
大面积烧伤
削痂术
高凝状态
血栓形成
TM
AT-Ⅲ
large area of bums
tangential excision
hypercoagulable state
thrombosis
TM
AT-Ⅲ
