颅脑损伤病人早期凝血功能与损伤程度及预后的相关性研究

THE STUDY OF CORRELATION AMONG EARLY COAGULATION FUNCTION AND SEVERITY AND PROGNOSIS IN TRAUMATIC BRAIN INJURY

目的:探讨颅脑损伤(TBI)病人凝血功能的变化及其与颅脑损伤程度与预后的关系。方法:依据格拉斯哥昏迷评分(GCS)将95例颅脑损伤病人分为轻、中、重度损伤三组,测定其入院时的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)和D-二聚体(DD)的水平,并与30例健康体检者(对照组)作对照。治疗1mo后依据牛津残障评分(OHC)对所有病人的预后进行评估,并将其分为预后良好组和预后不良组,比较两组病人的PT、APTT、PLT和DD水平。结果:随着伤情的加重,TBI病人的PT、APTT和DD水平依次增加,而PLT依次下降,差异均有统计学差异(P<0.01)。与预后良好病人,预后不良病人的PT、APTT和DD水平明显增高,而PLT水平明显降低,均有统计学差异(P<0.01)。结论:TBI病人凝血功能与颅脑损伤程度和预后密切相关,可用于病情评估和预后判断。

Objective： To explore the correlation among early coagulation function,severity and prognosis in traumatic brain injury（TBI）.Methods： A total of 95 TBI cases were divided into mild,moderate and severe injury groups based on GCS,and the levels of PT,APTT,PLT and DD were measured on admission,compared with those in 30 healthy controls（control group）.After one-month treatment,Oxford handicap scale was employed to assess the prognosis of all the TBI patients,based on that all the TBI patients were divided into the favarable and poor prognosis groups,and the above-mentioned indices were compared between two groups.Results： The levels of PT,APTT and DD were progressively elevated with increasing disease severity,while the PLT level was decreased.The results showed significant differences between all groups（P〈0.01）.The levels of PT,APTT and DD were markedly increased in the poor prognosis group than in the favorable group,while the PLT level was considerably reduced and there were significant differences between two groups（P〈0.01）.Conclusion： Early coagulation function proves to be associated closely with the severity and prognosis,aiding in assessing the severity and judging the prognosis in TBI.