Ishikawa Kouhei, Omori Kazuhiko, Jitsuiki Kei, Ohsaka Hiromichi, Ito Hiroshi, Shimoyama Katsuhito, Fukunaga Toru, Urabe Norikazu, Kitamura Souichirou, Yanagawa Youichi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan.
Numazu City Hospital, Numazu, Japan.
Air Med J. 2017 Mar-Apr;36(2):59-61. doi: 10.1016/j.amj.2016.12.009. Epub 2017 Feb 2.
We retrospectively analyzed trauma patients who were transported by a physician-staffed helicopter (doctor helicopter) to investigate the clinical significance of the fibrinogen degradation product (FDP) level on arrival.
From February 2011 to July 2016, a medical chart review was retrospectively performed for all patients with trauma who were transported by the doctor helicopter. The subjects were divided into 2 groups: a survival group and a fatal group.
There were 135 patients in the survival group and 16 in the fatal group. The ratio of head injury, value of Injury Severity Score (ISS), and level of FDP in the fatal group were significantly greater than in the survival group. The average Glasgow Coma Scale and systolic blood pressure in the fatal group were significantly smaller than in the survival group. The FDP level at arrival was positively associated with the ISS (R = 0.74, P < .0001). After excluding subjects with shock, unconsciousness, and head injury, the FDP level was still positively associated with the ISS (R = 0.60, P < .0001).
Therefore, the FDP level may be a useful biochemical parameter for the initial evaluation of the severity of trauma, even in blunt trauma patients without head injury or with stable vital signs.
我们回顾性分析了由配备医生的直升机（医生直升机）转运的创伤患者，以研究入院时纤维蛋白原降解产物（FDP）水平的临床意义。
对2011年2月至2016年7月期间由医生直升机转运的所有创伤患者进行回顾性病历审查。将受试者分为2组：存活组和死亡组。
存活组有135例患者，死亡组有16例患者。死亡组的头部损伤比例、损伤严重程度评分（ISS）值和FDP水平均显著高于存活组。死亡组的平均格拉斯哥昏迷量表评分和收缩压显著低于存活组。入院时的FDP水平与ISS呈正相关（R = 0.74，P <.0001）。排除休克、昏迷和头部损伤患者后，FDP水平仍与ISS呈正相关（R = 0.60，P <.0001）。
因此，即使在无头部损伤或生命体征稳定的钝性创伤患者中，FDP水平也可能是创伤严重程度初始评估的有用生化参数。
