急性颅脑损伤后血凝障碍的临床与实验室研究

Clinical and laboratory study on blood coagulation disorder after acute head injury

目的 探讨急性颅脑损伤后血凝障碍的临床意义。方法 对 75例急性脑外伤患者伤后不同时间分别测定八项血凝指标 ,结合临床及影像学资料 ,进行比较分析。结果 伤后 2 4h内血凝指标检测结果与伤后 7d、1 4d比较均有非常显著的差异 ;按伤情轻重以及有无迟发出血进行分组比较 ,均具有统计学意义。结论 急性脑损伤后血凝障碍主要发生在伤后 2 4h内 ,与脑实质损伤程度及迟发颅内出血密切相关。检测结果出现三项以上异常 ,对预测迟发出血有重要价值 ;D dimer血浆水平≥ 8mg/L时 ,可作为预后险恶的可靠指标。

Objective To study the clinical significances and relationship between the mechanism of blood coagulation and acute head injury. Methods Eight items of blood coagulation in 75 cases were measured for 24h,7d and 14d after injury.The results were analyzed and compared with control group.Then,according to the situation,the cases were divided into different groups and the results were analyzed.Results The blood coagulation index determined between different groups and control group was significant( P <0.01) in 24h after head injury.D-dimer abnormal ratio was the highest one in the eight indexes.Conclusion Blood coagulation disorder mainly happened within 24h after head injury.The blood coagulation disorder was closely related to the degree of brain damage and delayed intracranial hemorrhage.The three more indexes abnormality of blood coagulation were a valuable prediction for the delayed intracranial hemorrhage.If D-dimer≥8mg/L,it can be a mark of inauspicious prognoses.