| Objective A retrospective analysis of the medical records of burn sepsis patients in the Department of Burns and Plastic Surgery of the General Hospital of Ningxia Medical University was conducted to explore the relationship between changes in coagulation parameters and the severity of burn sepsis patients and their significance to the prognosis of patients.Methods The cases were selected from June 2016 to September 2018 in the Department of Burns and Plastic Surgery of the General Hospital of Ningxia Medical University,aged 18-50 years old,and regularly detected blood coagulation indicators and blood routine for severe and severe burns.A total of 110 patients,the following two Partially selected from their respective selection criteria.1.The relationship between the changes of coagulation parameters and the severity of the disease in patients with burn sepsis.According to the diagnostic criteria for sepsis,110 eligible cases were divided into 44 cases in the simple infection group,36 cases in the sepsis group,and 30 cases in the septic shock group.The sex,age,total burn area,third-degree burn area and and presence of combined inhalation injury were recorded in the three groups.Compare the changes of serum indicators(PLT,APTT,PT,FIB,D-dimer)of the three groups of patients on the first,third and fifth day of diagnosis and analyze their clinical significance.2.Significance of changes in coagulation parameters of patients with burn sepsis on patients' prognosis.The 64 eligible cases were divided into 39 survival groups and 25 death groups according to the prognosis of the patients.The gender,age,total burn area,third-degree burn area,and presence of combined inhalation injury were recorded in the two groups.The two groups were compared.Changes in serum indicators(PLT,APTT,PT,FIB,D-dimer)on the first,third,and fifth days of diagnosis were analyzed and their clinical significance was analyzed.Results1.The relationship between the changes of coagulation parameters and the severity of the disease in patients with burn sepsisOn the first day of diagnosis,the PLT value of the sepsis group and the septic shock group was significantly lower than that of the control group,and the difference was statistically significant(p <0.05).The APTT and PT of the sepsis group and the septic shock group were longer than those of the control group;the D-dimer value was higher than that of the control group,and the difference was statistically significant(p <0.05).Correlation analysis showed that there was a negative correlation between PLT and the severity of the patient's condition on the first day of diagnosis(correlation coefficient r =-0.651,p <0.05),there was no significant correlation between the FIB value and the severity of the patient's condition,and the remaining indicators were severely related to the patient's condition.The degree was positively correlated;analysis of the ROC curves of all indicators on the first day showed that APTT,PT,FIB,and D-dimer had certain predictive significance for the occurrence of burn sepsis(p <0.01).Among them,the prediction significance of D-dimer is the most significant.On the third day of diagnosis,the PLT values of the sepsis group and the septic shock group were significantly lower than those of the control group,and the difference was statistically significant(p <0.05).The APTT and PT of the sepsis group and the septic shock group were longer than those of the control group;the values of FIB and D-dimer were higherthan those of the control group,and the differences were statistically significant(p <0.05).Correlation analysis showed that the PLT value on the third day of diagnosis was negatively correlated with the severity of the patient's condition(correlation coefficient r =-0.668,p<0.05),and the other indicators were positively correlated with the severity of the patient's condition;for each indicator on the third day Analysis of the ROC curve showed that APTT,PT,FIB,and D-dimer had certain predictive significance for the occurrence of burn sepsis(p<0.01).Among them,the prediction significance of D-dimer is the most significant.On the 5th day of diagnosis,the PLT value of the sepsis group and the septic shock group was significantly lower than that of the control group,and the difference was statistically significant(p <0.05).The APTT and PT of the sepsis group and the septic shock group were longer than those of the control group;the values of FIB and D-dimer were higher than those of the control group,and the differences were statistically significant(p <0.05).Correlation analysis showed that the PLT value on the 5th day of diagnosis was negatively correlated with the severity of the patient's condition(correlation coefficient r =-0.668,p <0.05),and the other indicators were positively correlated with the severity of the patient's condition;Analysis of the ROC curve showed that APTT,PT,FIB,and D-dimer had certain predictive significance for the occurrence of burn sepsis(p <0.01).Among them,the prediction significance of D-dimer is the most significant.2.Significance of changes in coagulation parameters of patients with burn sepsis on patients' prognosisOn the first day of diagnosis,the PLT value in the death group was lower than that in the survival group,and the D-dimer was higher than that in the survival group.The differences were statistically significant(p <0.05),and the other indicators were not statistically significant.The correlation analysis showed: The PLT on the first day of diagnosis was negatively correlated with the patient's prognosis,and the remaining indicators were positively correlated with the patient's prognosis.The ROC curve of each indicator on the firstday showed that all indicators except PLT had a certain poor prognosis for patients with burn sepsis.Predictive significance(p <0.05).Among them,the prediction significance of D-dimer is the most significant.On the third day of diagnosis,the PLT value of the death group was lower than that of the survival group,and the other indicators were higher than those of the survival group,and the differences were statistically significant(p <0.05).Correlation analysis showed that the PLT on the third day of diagnosis was associated with the prognosis of patients.Negative correlation.Except that the PT and FIB values have no significant correlation with the patient's prognosis,the other indicators are positively correlated with the patient's prognosis.The ROC curve of each indicator on the third day shows that all indicators except for PLT are related to burn sepsis patients.Poor prognosis has certain predictive significance(p <0.05).Among them,the prediction significance of APTT is the most significant.On the 5th day of diagnosis,the PLT value of the death group was lower than that of the survival group,and the other indicators were higher than those of the survival group,and the differences were statistically significant(p <0.05).Correlation analysis showed that PLT on the 5th day of diagnosis was associated with prognosis Negative correlation,the other indicators were positively correlated with the patient's prognosis;the ROC curve of each indicator on the 5th day showed that with the exception of PLT,the other indicators had certain predictive significance for the poor prognosis of patients with burn sepsis(p <0.05).Among them,the prediction significance of D-dimer is the most significant.Conclusion1.PLT,APTT,PT,FIB and D-dimer are closely related to the occurrence and development of burn sepsis patients,and D-dimer has important predictive significance for the occurrence of burn sepsis.2.PLT,APTT,PT,FIB and D-dimer are closely related to the prognosis of burn sepsis patients,and APTT,D-dimer can be used as reference indicators for judging the prognosis ofburn sepsis patients;Although burn sepsis Patients may have a decreased PLT value,but its significance in predicting the prognosis of patients with burn sepsis is not significant.3.The SOFA score and APACHEII score are closely related to the occurrence of adverse prognosis in burn sepsis patients,it can be used as reference indicators for judging the prognosis of burn sepsis patients. |
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