| Objective:To analyze the dynamic changes of platelets,TEG parameters,and coagulation function in severe and very severe adult burn patients,and explore the characteristics and trend of changes in coagulation dysfunction in severe and very severe patients,and the correlation between TEG parameters and conventional coagulation indicators.Methods:A retrospective study was conducted to collect the clinical data of adult patients admitted to Guangzhou Red Cross Hospital from January 2020 to December 2020 who were diagnosed with severe and extremely severe burns.According to the burn records recorded at the time of admission,such as TBSA and the area of third-degree burns and Inhalation injury,the patients were divided into severe burn group and very severe burn group,and the two groups of patients were collected on admission and at48 h,72h,7d,14 d and 21 d after injury.Perform blood routine,thromboelastogram monitoring(TEG)and routine coagulation function tests on the blood samples,dynamically observe and compare the trends of various indicators in the two groups within 21 days,and analyze the correlation between the TEG parameters,platelet content and coagulation indicators at different checkpoints.Results:1.The platelets of severe and very severe burn patients dropped sharply when they were admitted to the hospital and showed a low state.After a week,they gradually rose to close to the normal level,and then rose sharply in the following week.After 21 days of injury,they stabilized and showed higher than normal levels,and the possibility of thrombosis increased.The platelet content of the severe group was significantly higher than that of the severe group 21 days after injury.2.Within 21 days after injury,the APTT of patients in the severe burn group was greater than that of the severe burn group in the early stage of burn.The AT-III content gradually decreased in the early stage of burns,then gradually rose to the highest value within a week and then gradually decreased.At the time of admission and 48 hours after the burn,the content of AT-III in the very severe group was significantly lower than that in the severe group(P<0.05).The average FIB value of all checkpoints within 21 days after the burn was greater than the upper limit of normal 4.0(g/L),and the overall appearance first increased to the highest value 7 days after the injury and then gradually decreased.At all checkpoints,the FIB content of very severe burn patients was higher than that of the severe group.The average DD of all checkpoints within 21 days after burn was greater than the upper limit of normal500(μg/L).PT decreased slightly in the early post-injury period,and increased significantly in the following two weeks.The average value of all checkpoints is within the normal range(10.5-13.5s).3.The change trend of the R value of all patients after admission showed an overall increase to the highest value on the 7th day after injury and then gradually decreased.The mean values of all checkpoints are within the normal range.At all checkpoints,the R value of patients in the very severe group was greater than that of the severe group.The K value of all patients showed a trend of gradual decrease as the burn time increased.In the early stage of burn(within 7 days of burn),the K value of patients in the very severe group was higher than that of the severe group,and then the opposite.The change trend of ɑ angle of all patients after admission showed a trend of increasing with the increase of burn time.21 days after the burn,the mean ɑ angle of the patients in the very severe group was significantly greater than that in the severe group.The change trend of MA value of all patients after admission showed a trend of gradually increasing with the increase of burn time.21 days after the burn,the average MA value of patients in the very severe group was significantly greater than that in the severe group.After admission,the CI values of all patients showed a trend of increasing gradually with the increase of burn time,and the average CI values of all checkpoints were within the normal range.In the pre-burn period,the CI value of the severe group was greater than that of the severe group,and the CI value of the severe group was greater than that of the severe group at 21 days after the burn.4.Correlation analysis results of 48 h TEG and platelet count and coagulation test parameters after burn showed that CI value was significantly positively correlated with platelets,K value was significantly negatively correlated with AT-III and platelets,and MA value was significantly positively correlated with AT-III and platelets,R value is significantly negatively correlated with platelets,ɑ angle is significantly positively correlated with AT-III and platelets;the correlation analysis results of 21 d TEG after burns with platelet count and coagulation test parameters show that CI value is significantly positively correlated with FIB and platelets,and MA value It is significantly positively correlated with FIB and platelets,R value is significantly positively correlated with APTT and PT,and ɑ angle is significantly positively correlated with FIB and platelets.Conclusions:1.The platelet content of very severe patients increased sharply in the late stage of burn,which indicates that the possibility of thrombosis in patients is increased.2.Severe and extremely severe burn patients showed obvious abnormalities in coagulation function upon admission.Due to the consumption of coagulation factors,APTT and PT values were significantly prolonged,while R values were increased and CI values were decreased.If they were to get up from the initial stage,they would get up from the initial stage to get up from the initial stage to get up from the initial stage.3.There is a certain correlation between the TEG parameters of severe and very severe burn patients,platelets and conventional coagulation indicators. |
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