急性颅脑损伤后凝血功能改变对预后的评估价值

Value of coagulation changes for evaluating the prognosis after acute craniocere bral injury

目的:观察急性颅脑损伤患者凝血与纤溶系统参数的变化并探讨其临床意义。方法:检测解放军第三医院神经外科收治的67例头部创伤且有颅脑损伤患者、72例头部创伤但无颅脑损伤的患者和65例健康人血浆凝血酶原时间prothrombintime,PT)、活化部分凝血活酶时间activatedpar-((tialthromboplastintime,APTT)、凝血酶时间thrombintime,TT)、纤维蛋(白原(fibrinogen,Fg)、纤维蛋白原降解产物(fibrinogendegradationprod-ucts,FDP)、D-二聚体D-dimer,DD及血小板计数plateletcount,PLT)()(变化。结果:颅脑损伤组患者PT,APTT,TT,Fg,PLT,DD和FDP结果分别为(5.90±11.8),(19.8±4.91),(18.7±5.32)s,(1.47±0.98)g/L,(82±21)×109L、(503±73)μg-1/L和29.8±4.69)mg/L。与对照组(和无颅脑损伤的头部创伤患者相比,颅脑损伤患者急性期PT,APTT缩短(P<0.05),Fg,PLT降低(P<0.05),FDP,DD升高(P<0.01)。结论:颅脑损伤患者急性期外周血处于高凝状态和纤溶亢进。

AIM: To observe the changes of coagulation and fibrinolysis system parameter i n patients with acute craniocerebral injury, and study their clinical significan ces. METHODS:The prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(Fg), fibrinogen degradation products(FDP), D dim er (DD) and platelet count (PLT) were detected in 67 head injured patients with craniocerebral injury, 72 head injured patients without craniocerebral injury, w ho were treated in the Department of Neurosurgery,the 3 Hospital of Chinese PLA, and 65 normal controls. RESULTS: The PT, APTT, TT, Fg, PLT,DD and FDP in the craniocerebral injury gro up were(5.90±11.8),(19.8±4.91),(18.7±5.32) s,(1.47±0.98) g/L,(82±21)×109 L -1, (503±73) μg/L and(29.8 ±4.69) mg/L.Compared with the normal control grou p and non craniocerebral infarction group, PT and APTT were shortened(P< 0.05), Fg and PLT were reduced (P< 0.05),while FDP and DD were increased (P< 0.01) in patients with acute craniocerebral injury. CONCLUTION: There are hypercoagulability and hyperfibrinolysis in the peripher al blood of patients with acute craniocerebral injury.