凝血指标协助判断外伤性颅内出血是否稳定的临床分析

Clinical Analysis of Blood Coagulation Indicator in Judging the Stability of Traumatic Intracraninal Hemorrhage

目的研究凝血指标能否协助判断颅脑损伤颅内出血稳定与否,是否可作为病情变化的重要的临床客观依据。方法回顾性分析81例颅脑损伤患者的凝血指标的变化,结合GCS评分及头颅CT结果 ,判断凝血指标异常与出血增多的关系。结果在81例中,有15例经复查头颅CT发现出血增多,66例出血未增多,出血增多组均有3项以上凝血指标增高,其中APTT及D-二聚体均增高;出血未增多组凝血指标基本正常,一般只有D-二聚体增高,仅有6例出现2项增高,未见3项以上增高。结论凝血指标尤其是PT秒值、PT-INR、APTT、纤维蛋白原、D-二聚体这5项指标的异常对于判断颅脑损伤出血增多与否是有一定意义的,尤其3项以上增高,应高度怀疑出血可能增多。凝血指标可以作为协助判断外伤性颅内出血稳定与否的临床指标之一。

Objective To study the clinical significance of blood coagulation indicator in judging the stability of traumatic intracraninal hemorrhage.And to investigate whether the blood coagulation indicator can be the important clinical objective basis in judging the stability of traumatic intracraninal hemorrhage.Methods The blood coagulation indicator of 81 cases of traumatic intracraninal hemorrhage was retrospectively analyzed,admission Glascow coma scale（GCS）and CT were used to evaluate the influence of blood coagulation disorder on the patients of traumatic intracraninal hemorrhage.Results 15 cases of delayed intracranial hemorrhage by CT were found in 81 cases of traumatic intracraninal hemorrhage,in another 66 cases,which were not found.There were more than three indicators abnormality of blood coagulation in 15 cases of delayed intracranial hemorrhage,in which the APTT and D-dimmer were both heightened in every cases.In another group,more than three indicators abnormality of blood coagulation can not be found.Conclusion Blood coagulation indicator（PT,PT-INR,APTT,Fbg,D-D）can be the important clinical objective basis in judging the stability of traumatic intracraninal hemorrhage.The more than three indexes abnormality of blood coagulation were a valuable prediction for the delayed intracranial hemorrhage.