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Objective: To study the multiple trauma patients thromboelastography indicators of the dynamic changes in the law, and the conventional coagulation indicators, as well as temperature Thromboelastography test results, in order to assess the value of Thromboelastography applications in multiple trauma patients. Methods: This study was a prospective observational study, study multiple trauma patients admitted into the Second Affiliated Hospital, Zhejiang University School of Medicine, Emergency Care Unit (EICU) for January 2010 - June 2010. Detected in patients 1, 3 and 7 days thromboelastography each index {R (reaction time), K (clot formation time), Angle (rate of clot formation), MA (maximum amplitude), CI (coagulation index)}, platelet count (platelet count PLT), fibrinogen (fibrinogen FIB), prothrombin time (prothrombin time PT), activated partial thromboplastin time (activated partial thromboplastin time APTT), and at different temperatures under (37 ° C, 35 ° C, 33 ℃) Thromboelastography of each indicator (R, K, angle, MA, CI). The recordable injury after the first day of the injury severity score (Injury severity score ISS), Glasgow Coma Score (Glasgow coma score GCS), Acute Physiology and Chronic Health Evaluation Ⅱ system (Acute physiologyand chronic health evaluation II APACHII). To the SPSS17.0 or SigmaStat3.5 Statistical Package for the analysis of multiple trauma patients injured thromboelastography indicators dynamic variation, comparing different degree of injury, changes in the characteristics of patients with different prognosis thromboelastography indicators and differences. Analysis of multiple injuries thromboelastography indicators in patients with conventional coagulation parameters (APTT, PT), FIB, PLT correlation. Analysis thrombelastometry Figure CI with ISS, GCS, APACHII of correlation, multiple linear regression analysis, screening various time points after injury thromboelastography the CI significantly related indicators. Analytical The thromboelastography CI's value in predicting the prognosis of patients with multiple injuries. Analyze temperature impact thromboelastography indicators. The results: patients with multiple trauma injuries K value of thromboelastography downward trend over time, Angle, MA, CI upward trend. Lt; 25 compared with the ISS, the ISS ≥ 25 group slower decline in the value of K at each time point values ??are too large, Angle, MA, CI early trauma on the low side, and each time point values ??are less than the latter. Death group, the value of K, R values ??were significantly higher than the survival group at each time point were higher than the latter; Angle, MA, PLT, CI was significantly lower than the survival group, and rising slowly, at each time point values ??are lower than the latter. Multiple trauma patients thromboelastography R and APTT, PT 1,3,7 day was positively correlated K and FIB was negatively correlated with the first day was positively correlated with Angle and FIB 1,3, MA with PLT in 1,7 days was positively correlated with the MA and FIB was positively correlated with the first day. Thrombelastography R K value gradually increased with decreasing temperature, while Angle, MA, CI decreased gradually with the decrease of temperature. At 37 ° C under coagulation function abnormalities in patients with R, K increased rapidly with decreasing temperature, and at each temperature point were higher than 37 ° C under coagulation normal, Angle, MA, CI is just the opposite. Conclusion: 1, multiple injury patients with early to coagulation dysfunction occurs, the change has a certain regularity, with the severity and prognosis. The thromboelastography Figure dynamically evaluate changes in blood coagulation, and provide the basis to take timely and appropriate clinical decision-making. Thromboelastography K Angle, FIB, MA and PLT good correlation, while the former can reflect the functional status of fibrinogen and platelets, is superior to the traditional number of parameters were measured. 3, low temperature on coagulation has a greater influence, while the TEG can be measured at any temperature, to more accurately reflect the actual body temperature of the patients under the coagulation function.
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