Clinical Study On The Changes Of Coagulation Function In Patients With Severe Trauma In Qinghai At Different Admission Time

Objective: Observe the changes of coagulation function in patients with severe trauma in different admission time in Qinghai area;compare the incidence of acute traumatic coagulopathy in patients with severe trauma in different ad mission periods;compare the diagnosis rate of acute traumatic coagulation in conventional coagulation test and thrombelastography.Method: Collect 67 cases of severe trauma patients(ISS > 25 points)admitted to the emergency ICU and severe ICU of our hospital from October 2017 to December 2018 in Qinghai.According to the time period(T)from the time of injury to the time of admission,patients were divided into groups,that is,the 2-hour group and the 4-hour group.After admission,conventional coagulation test(CCT)and thrombelastography(TEG)were performed immediately.According to the determination criteria of acute traumatic coagulopathy(ATC),the two groups were divided into the occurrence group and the non-occurrence group.First,analyze the general data statistically,then compare the diagnosis rate of ATC between the two groups and within the two groups,and compare the changes of each value index of the two test methods between the two groups.Finally,Conduct the correlation analysis of each index of the two test methods.Results:(1)The incidence of ATC in patients with severe trauma in the 4h group was greater than that in the 2h group,but the difference was not statistically significant.(2)The incidence of ATC determined by TEG index in the 2h group and the 4h group was higher than that determined by CCT index.Kappa test indicated that the two methods had moderate consistency in the diagnosis of ATC.(3)Correlation analysis of each index of the two examination methods indicated that R value and MA were correlated with PT,APTT,TT and PTR,K value was correlated with TT,and Angle was correlated with PT(p<0.05).Conclusion:(1)Patients with severe trauma in Qinghai were mainly male,with an average age of 48.3±17.5 years old.The main cause of injury was car accident injury,followed by high-altitude fall injury.(2)The 2 hours and 4 hours of severe trauma hospitalized patients in Qinghai on the basis of CCT and TEG to determine the incidence of ATC is respectively 44.8% and 66.5%(2h group),55.2% and 76.3%(4h group),part of patients with severe trauma had happened ATC before the injured to hospital,longer duration of hospital,the incidence of ATC may continue to increase.(3)In ATC detection,TEG test has a higher detection rate than CCT test.At the same time,the two showed moderate consistency in the diagnosis of ATC.