Namias N, McKenney M G, Martin L C
Department of Surgery, University of Miami/Jackson Memorial Medical Center, FL, USA.
J Trauma. 1996 Jul;41(1):21-5. doi: 10.1097/00005373-199607000-00005.
To determine whether abnormal results of admission serum chemistry profiles (P7: sodium (Na), potassium (K), chloride (Cl), carbon dioxide content (CO2), blood urea nitrogen (BUN), creatinine (Cr), and glucose (GLU), amylase (AMY), and coagulation profiles (CP: prothrombin time (PT) and partial thromboplastin time (PTT) in trauma patients lead to clinical interventions, and to characterize frequency of abnormal results, we prospectively gathered laboratory data on 500 consecutive patients seen in our Level 1 trauma center. Clinicians were blinded to the study. Abnormal results were found in 93% of P7s, 7% of AMYs, and 59% of CPs. Interventions were made for < 1% of abnormal P7s, 0% of abnormal amylase, and 5% of patients with abnormal CP. We conclude that information provided by routine admission chemistry and coagulation profiles in trauma patients seldom lead to clinical interventions. These tests should not be ordered routinely on admission in trauma patients.
为了确定创伤患者入院时血清化学指标（P7：钠（Na）、钾（K）、氯（Cl）、二氧化碳含量（CO2）、血尿素氮（BUN）、肌酐（Cr）、葡萄糖（GLU）、淀粉酶（AMY））以及凝血指标（CP：凝血酶原时间（PT）和活化部分凝血活酶时间（PTT））的异常结果是否会导致临床干预，并描述异常结果的发生率，我们前瞻性地收集了在我们一级创伤中心就诊的500例连续患者的实验室数据。临床医生对该研究不知情。P7指标中93%出现异常结果，AMY指标中7%出现异常结果，CP指标中59%出现异常结果。针对<1%的P7异常结果、0%的淀粉酶异常结果以及5%的CP异常患者进行了干预。我们得出结论，创伤患者入院时常规化学和凝血指标所提供的信息很少导致临床干预。创伤患者入院时不应常规进行这些检查。
