| Objectives:To evaluate the value of routine coagulation index and thromboelastic plot in evaluating the severity of wasps stings.Methods:Choose between January 2019 and December 2019 in north sichuan medical college affiliated hospital emergency department visits wasp sting injury treated 73 cases of patients,collect the patient’s general information on admission and hospitalization laboratory data such as data,according to sting injury severity is divided into three groups:light,medium and severe intoxication group,and a half hours after admission adept conventional coagulation and detection of thrombus elastic figure another 40 healthy subjects as control group in the same period,to compare clinical and laboratory parameters of the differences between groups.Pearson correlation method was used to analyze the correlation between coagulation function and thromboelastic map index and the degree of systemic organ injury(SOFA score and number of systemic organ involvement)of patients with wasp stings.Logistic regression analysis was used to analyze the MODS of patients with wasps stings.ROC was used to evaluate the predictive value of clotting function and thromboelastic plot in MODS of wasps stings.Results:1.There was no significant change in FIB and AT Ⅲ in group 4(P>0.05).PT and APTT were gradually prolonged with the aggravation of the disease(mild,moderate and severe)(P<0.05).Compared with the control group,INR in the three groups was prolonged(P<0.05),and no significant change was observed in the light,medium and heavy groups(P>0.05).Compared with the control group,PT(%)in the three groups decreased(P<0.05),and no significant change was observed in the light,medium and heavy groups(P>0.05).TT and p-fdp values in the severe group were higher than those in the control group,the mild group and the moderate group(P<0.05),while no significant changes were observed in the light,medium and control groups(P>0.05).SOFA score of patients with wasps stings was correlated with PT(r=0.339,P=0.003),APTT(r=0.415,P=0.000),and TT(r=0.252,P=0.034).The number of systemic organ involvement was correlated with PT(r=0.408,P=0.000),APTT(r=0.479,P=0.000)and TT(r=0.337,P=0.004).There was no correlation with other indicators of coagulation function.2.With the aggravation of the patient’s condition,R and K time gradually prolonged,a(deg)Angle gradually decreased(P<0.05).MA and CI in the severe group were lower than those in the light,medium and control groups(P<0.05),and there was no significant change between the light,medium and control groups(P>0.05).LY30 and EPL of patients in the three groups were higher than those in the control group(P>0.05),and there was no significant difference between the light,medium and heavy groups(P>0.05).SOFA score of patients with wasp stings was correlated with R(R=0.321,P=0.006)and a(deg)(R=-0.319,P=0.006).The number of systemic organ involvement was correlated with R(R=0.364,P=0.002)and a(deg)(R=-0.556,P=0.000).It was not correlated with other thromboelastic indexes.3.Logistic regression analysis to the wasp sting injury in patients with MODS factors affecting elastic figure index(normal coagulation function and thrombosis)analysis found that PT,APTT,extended a(deg)Angle decreases with the R value is a wasp sting injury in patients with risk factors of MODS,the wasp sting have predictive value of injury patients with MODS(PT:sensitivity 82.86%,specificity 69.44%;APTT:sensitivity 65.71%,specificity 94.44%.R:sensitivity 67.57%,specificity 77.78%;A(deg):sensitivity 59.46%,specificity 91.67%).Conclusion:Routine examination of clotting function and thromboelastic map of wasps stings on admission is of certain reference value in evaluating the severity of wasps stings. |
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