血浆辅助治疗对颅脑损伤合并凝血功能障碍患者预后的影响

Study on the effect of plasma adjuvant therapy on the prognosis of patients with traumatic brain injury complicated with coagulation disorders

目的探讨血浆辅助治疗对颅脑损伤合并凝血功能障碍患者预后的影响,为临床应用提供参考依据。方法选取本院60例颅脑损伤合并凝血功能障碍患者,采用随机数字法平均分为观察组与对照组,观察组给予血浆辅助治疗,对照组患者给予常规治疗,于治疗前、治疗后3d、7d、14d检测凝血功能及相关生化指标和髓鞘碱性蛋白(MBP)及神经元特异性烯醇化酶(NSE)并对其神经功能进行评价。结果治疗前2组患者血浆MBP、NSE水平比较差异无统计学意义(P>0.05);治疗后NSE水平较治疗前明显下降,差异有统计学意义(P<0.05),与对照组相比,观察组下降水平更明显(P<0.05);MBP水平于治疗后第3天开始升高,与治疗前比较差异有统计学意义(P<0.05),治疗后7d开始下降,且与对照组相比,观察组患者下降水平更明显(P<0.05)。凝血功能比较发现:治疗前2组患者凝血功能差异比较不明显(P>0.05),治疗后2组凝血指标均明显下降(P<0.05);与对照组相比,观察组患者PT、APTT、TT、FIB下降更明显(P<0.05)。治疗后2组患者GCS评分均有明显升高,但2组比较差异不明显(P>0.05)。结论血浆辅助治疗可更好改善颅脑损伤合并凝血功能障碍患者的凝血功能障碍,同时降低炎性反应的发生,但并未改善患者的预后。

Objective To Study the effect of plasma adjuvant therapy on the prognosis of patients with traumatic brain in-jury complicated with coagulation disorders.Methods 60 patients with craniocerebral injury complicated with coagulation dys-function were included and divided into observation group and control group. Patients in observation group were given the plas-ma auxiliary treatment. Patients in control group were given routine treatment. The serum level of blood coagulation function and related biochemical indicators were detected after treatment for 3 d ,7 d and 14 d.Results The differences of levels of MBP ,NSE before treatment between two group were not significant （P〉0.05）.The level of NSE after treatment was lower than that before treatment. The difference was statistical significanct （P0.05）.The levels of blood coagulation after treatment were lower than those be-fore treatment（P 0.05）.Conclusion Plasma adjuvant therapy effectively improves coagulation function ,re-duces the incidence of inflammatory reaction ,but Can not obviously improve the prognosis of patients with traumatic brain inju-ry.