颅脑损伤后凝血系统与纤溶系统改变的研究

Study on changes of coagulation and fibrolysis after Traumatic brain injury

目的通过对D-二聚体含量水平动态测定,观察颅脑损伤后凝血系统与纤溶系统异常改变和变化规律。方法用ACL-100型血凝仪对26例颅脑损伤患者入院时即刻、第2天、第3天、第7天的D-二聚体的含量和PT、KPTT的水平进行动态测定,结果发现D-二聚体含量水平与患者颅脑损伤程度密切相关。脑损伤患者治疗前D-二聚体含量水平与治疗后D-二聚体含量水平比较差异有显著性意义(P<0.01)。结论D-二聚体的含量增高,说明颅脑损伤患者处于高凝状态。并且临床使用止血剂等药物治疗后,D-二聚体的含量并没有增高,这说明可能是随后继发纤溶亢进的原因,因此颅脑损伤后脑组织的继发性损害与D-二聚体含量高低密切相关。所以D-二聚体可以作为颅脑损伤程度的一个可靠指标,对预后有重要意义。

Objective To investigate changes of coagulation and fibrolysis after traumatic brain injury （TBI） through detecting dynamic levels of serum D-dimer. Methods The D-dimers contents and the levels of PT KPTT were dynamicly detected on time of admission 2 days, 3 days and 7 days after TBI in 26 cases with ACL-100 model instrument of blood coagulation. Results There was close correlation between the contents of D-dimer and the extent of TBI. There was remarkable statistic significance of D-dimer contents before and after treatment of TBI （P〈0.01）. Conclusion It is indicated that the increased level of D-dimer is assoiated with high coagulation states of TBL.