目的:分析重度颅脑损伤患者急诊术后DVT形成的危险因素及血栓分子标志物联合Caprini评分对DVT形成的预测价值。方法:回顾性分析2023年01月至2024年08月就诊于安徽医科大学第二附属医院的116例患者的病历资料。根据入住ICU后的下肢血管超声结果分为病例组(n = 32)与对照组(n = 84),比较两组临床资料、D-D二聚体(D-D)、纤维蛋白原分解产物(FDPs)、血栓分子标志物水平[凝血酶–抗凝血酶III复合物(TAT)、纤溶酶-α2-纤溶酶抑制剂复合物(PIC)、血栓调节蛋白(TM)、组织型纤溶酶原激活物–抑制剂复合物(t-PAIC)]、Caprini评分及Caprini分级,采用单因素和多因素logistic回归分析重度颅脑损伤患者急诊术后下DVT形成的危险因素,通过绘制受试者工作特征(ROC)曲线分析TAT、TM、PIC、t-PAIC及四项指标联合Caprini评分对重度颅脑损伤患者急诊术后DVT形成的预测价值。结果:两组吸烟史、手术时长、术中输血史、FDPs、D-D二聚体、TAT、PIC、t-PAIC、Caprini评分及Caprini分级比较,组间差异有统计学意义(P Objective: To analyze the risk factors for deep vein thrombosis in patients with severe craniocerebral injury after emergency surgery and the predictive value of thrombotic molecular markers combined with Caprini assessment on DVT formation in patients with severe craniocerebral injury. Methods: We retrospectively analyzed the clinical record of 116 patients who were admitted to the second hospital of Anhui Medical University from January 2023 to August 2024. According to the results of ultrasound of lower limb blood vessels after admission to the ICU, the patients were divided into a case group (n = 32) and a control group (n=84). The medical records, the level of D-D dimers (D-D), fibrinogen breakdown products (FDPs), thrombosis molecular markers [thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), thrombomodulin (TM), and tissue-type plasminogen activator-inhib
目的:探讨脾切除后急性感染性暴发性紫癜(AIPF)的临床症状、体征及辅助检查指标等的变化,为此疾病的诊断与治疗提供参考方案。方法:回顾本科室2019年12月23日收治的1例患者的病历、临床表现、体征、实验室检查结果及诊治经过等,结合数据库中以“暴发性紫癜”与“脾切除”及“fulminant purpura”与“splenectomy”检索获得的相似病例,分析以及比较其临床特征、治疗过程以及预后,探讨可能的诊疗和防治措施。结论:肺炎链球菌导致急性感染性暴发性紫癜(AIPF)的发育免疫功能缺陷,如脾切除或者脾功能低下患者,早期识别和治疗能够改善患者预后。Objective: To investigate the changes in the clinical symptoms, signs and auxiliary examination indicators of acute infectious fulminant purpura (AIPF) after splenectomy, and to provide a reference plan for the diagnosis and treatment of this disease. Methods: The medical records, clinical manifestations, signs, laboratory test results, diagnosis and treatment process of one patient admitted to our department on December 23, 2019 were reviewed, combined with the similar cases retrieved by “fulminant purpura” and “splenectomy” in the database, the clinical characteristics, treatment process and prognosis were analyzed and compared, and the possible diagnosis and treatment measures were discussed. Conclusion: Streptococcus pneumoniae causes acute infectious fulminant purpura (AIPF) and is good for developmental immune deficiencies, such as splenectomy or hyposplenism, and early recognition and treatment can improve the prognosis of patients.
