ABSTRACT
Objective:To systematically analyse the blood coagulation features of coronavirus disease 2019 (COVID-19) patients.Methods:An electronic search in PubMed, Scopus, Web of Science, EMbase, and CNKI to collect studies related to the blood coagulation features of COVID-19 patients from 1 January 2020 to 1 May 2020. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Then, the platelet count, D-dimer value, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen of patients with different types of diseases were analyzed by using Stata12.0 software.Results:Thirty-nine retrospective studies involving 6 994 COVID-19 patients were included. The results of meta-analysis showed that:(1) compared with severe group, the platelet count (Weighted mean difference; WMD=20.11, 95% CI 11.53 to 28.69, P<0.001) and APTT (WMD=1.30, 95%CI 0.31 to 2.30, P=0.01) were found to be higher while D-dimer (WMD=-0.41, 95%CI-0.58 to-0.24, P<0.001), fibrinogen (WMD=-0.58, 95% CI-0.76 to-0.39, P<0.001) and PT (WMD=-0.51, 95%CI-0.92 to-0.10, P<0.001) were lower in mild group; the platelet count (WMD=-14.75, 95% CI-29.73 to-0.23, P=0.044) was found to be lower while D-dimer (WMD=1.06, 95% CI 0.65 to 1.47, P<0.001) was found to be higher in critical ill patients. (2)Compared with the survival group, the patients in death group displayed elevated levels of D-dimer (WMD=6.86, 95% CI 4.15 to 9.57, P<0.001) and PT (WMD=1.37, 95% CI 0.73 to 2.02, P<0.001) while platelet count (WMD=-36.40, 95% CI-63.23 to-9.58, P=0.008) remained low. Conclusion:Coagulation dysfunction was common in severe, critical ill and dead COVID-19 patients. Platelet count, D-dimer and PT levels were associated with the severity of the disease, and thus could be used as early warning indicators for the deterioration of the disease during hospitalization.
ABSTRACT
To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18. 1 ± 3. 8)days vs. (36. 7 ± 11. 4) days], less hospital costs [(19429 ±4088)yuan vs. (33495 ±10712)yuan], less number of operations [(1. 1 ±0. 3)times vs. (2. 4 ±0. 8)times], higher level of satisfaction(56. 4％ vs. 30. 8％), lower relapse rate(5. 1％ vs. 26. 9％), the differences are statistically significant(all P <0. 05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.