凝血功能异常对急性颅脑损伤患者预后的影响

Analysis of coagulation abnormalities on the prognosis of patients with acute brain injury

目的探讨凝血功能异常对急性颅脑损伤患者预后的影响。方法选取2010-01—2012-03来本院就诊的重型颅脑损伤186例为实验组,选取本院同期健康体检者70例为对照组,检测PT、Fb、D-D、Plt含量。实验组患者均于入院24h、3d、7d、14d时检测凝血指标,对照组晨起抽取空腹血检测。结果实验组患者入院24h内凝血功能异常发生率42.47%(79/186),入院3d发生率24.19%(45/186),入院7d发生率4.79%(8/167),入院14d发生率3.27%(5/153)。入院24h内凝血功能异常发生率显著高于7、14d,差异有统计学意义(P<0.05)。实验组患者入院后24h内PT、Fb、D-D、Plt与对照组比较,差异均有统计学意义(P<0.05);入院7、14d,D-D显著高于对照组,差异有统计学意义(P<0.05)。结论对颅脑损伤患者病情及预后的评估,不能仅依靠影像学手段,同时要参考凝血功能等实验室检查。

Objective To analyze the influence of coagulation abnormalities on the prognosis of patients with acute brain injury. Methods From January 2010 to March 2012, 186 cases of severe traumatic brain injury patients in our hospital were se lected as the experimental group, 70 cases of healthy people as control group. The levels of PT, Fb, D-D, Pit were tested. The coagulation of experimental group patients admitted to our hospital within 24 h, 3 d, 7 d, 14 d were detected, and the early morning fasting blood of the control group patients was tested. Results In the experimental group patients within 24 h after admission, the incidence rate of coagulation dysfunction was 42. 47% （79/186）, the incidence rate was 24.19%（45/186） 3 days after injury, the incidence rate was 4.79%（8/167） 7 days after injury, the incidence rate was 3.27%（5/153） 14 days af- ter injury. The incidence of coagulation abnormalities within 24 h after injury was significantly higher than that after injury of 7, 14 d （P〈0.05）. Compared with control group,the levels of PT,Fb,D-D, Plt in experimental group of patients within 24 h after admission were significantly different,the level of D-D was significantly higher after injury of 7,14 d （P〈0.05）. Conclusion For traumatic brain injury patients, the assessment not only is relay on imaging methods, but also refers to the coagulation.