The Clinical Study Of Platelet Changes In Patients With Traumatic Splenectomy In Xining Area

Objective To study the changes of platelet parameters in patients with traumatic splenectomy in Xining area and analyze the influencing factors of PLT on the 14 th day after operation.Methods Retrospectively analyzed medical records of patients with traumatic splenectomy in department of emergency surgery of People’s Hospital of Qinghai Provincial from April 2013 to December 2016.According to a unified inclusion and exclusion criteria,medical records which meet the research standards above were collected randomly.The platelet parameters(platelet count,platelet mean volume,plateletcrit,platelet volume distribution width)of the first day,the third day,the seventh day,the 10 th day,the 14 th day are recorded respectively.The trend and rule of change over time of platelet parameters were analyzed.Then according to the factors such as sex,age,race,injury,shock,blood transfusion,time from injury to operation,infection,preoperative platelet count to make an analysis of the factors affecting the increase degree of platelet count on the 14 th day after operation.Results 1.The platelet count and plateletcrit were significantly different between every two groups of different time points(p<0.05),with the lowest in the preoperative period and the highest on the 14 th day after operation.The average platelet volume was no significant difference between the preoperative group and the postoperative day 1 group(p>0.05),and the difference between the every two groups of the rest groups was statistically significant(p<0.05).So was the platelet distribution width.The lowest of the two parameters were on the 14 th day after operation.2.The results of univariate analysis showed that age,injury,blood transfusion and infection were the influencing factors of PLT on the 14 th day after traumatic splenectomy in Xining area(p<0.05),the influences of sex,national,spleen injury grade,shock on the PLT of the 14 th day after operation were not statistically significant(p>0.05).The effect of shock on PLT at 14 days postoperatively was unclear and need to be further analyzed in multivariate analysis.3.The results of multivariate analysis showed that age,injury,blood transfusion and infection were the influencing factors of PLT on the 14 th day after traumatic splenectomy in Xining area(p<0.05).The influence of shock on the PLT of the 14 th day after operation was not statistically significant(p>0.05).And the regression equation was Y = 724.890-3.305×age + 65.839×injury + 0.074×blood transfusion-66.231× infection.4.Pearson correlation analysis showed that PLT on the 14 th day after operation was positively correlated with preoperative PLT(r = 0.450,p<0.05).Conclusions 1.The platelet count and plateletcrit increased gradually over time after the traumatic splenectomy in Xining area and the quantity of platelet volume and platelet distribution width decreased gradually over time in two weeks.2.Age,injury,blood transfusion and infection were the influencing factors of PLT elevation on the 14 th day after operation in patients with traumatic splenectomy in Xining area.3.Patients with younger age,the more severe injury,the more blood transfusion and the higher the preoperative PLT might face the higher PLT on the 14 th day after operation.And infection might have a certain inhibitory effect on the elevation of PLT on the 14 th day after operation.