颅脑外伤后迟发性颅内出血与凝血机制异常的关系研究

Study on Delayed Intracranial Hemorrhage and the Relationship Between Abnormal Blood Coagulation after Craniocerebral Trauma

目的研究颅脑外伤后发生迟发性颅内出血与凝血机制异常之间的临床关系。方法选取在2016年1月-2017年5月入住我院并将医生确诊为颅脑外伤的76例患者进行回顾性调查研究,其中有23例发生迟发性颅内出血(观察组),53例患者没有发生迟发型颅内出血(对照组)。对两组患者迟发性颅内出血的相关危险因素以及各项临床凝血功能指标进行对比分析。结果经比较,观察组的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(aPTT)均较对照组延长,而观察组的血小板计数(PLT)则明显低于对照组(P<0.05。经过单因素分析后患者的年龄、合并症、GCS评分以及凝血功能是造成迟发颅内出血的危险因素。数据代入Logistic多因素回归模型分析发现凝血功能、合并症以及GCS评分是迟发颅内出血的独立危险因素。结论颅脑外伤后发生迟发性颅内出血与凝血机制异常之间具有紧密的相关性,同时,临床还应密切关注年龄、合并症、GCS评分的各因素,预防颅脑外伤后发生迟发性颅内出血。

Objective To study the clinical relationship between delayed intracranial hemorrhage and abnormal coagulation mechanism after traumatic brain injury. Methods A retrospective study was conducted on 76 patients who admitted to our hospital from January 2016 to May 2017 and who were diagnosed as having craniocerebral trauma. Among them, 23 patients had delayed intracranial hemorrhage （ observation group） , 53 eases of patients without delayed intracranial hemorrhage occurred （ control group）. The two groups of patients with delayed intracranial hemorrhage related risk factors and clinical coagulation function of a professional comparison. Results The observation group, thrombin time （ TT）, prothrombin time （ PT）, activated partial thromboplastin time（aPTT）,were significantly greater than the control group and the observation group, the platelet count （PLT） was significantly lower than the control group （ P 〈 0.05 ）. by univariate analysis after the patient＇ s age, complications, GCS score and blood coagulation is caused by delayed intracranial hemorrhage. The number of risk factors According to a number of factors by Logistic regression model analysis showed that the coagulation function, complications and GCS score were independent risk factors of delayed intracranial hemorrhage. Conclusion The occurrence of delayed intracranial hemorrhage have a close correlation between abnormal blood coagulation, and after craniocerebral trauma at the same time, should also pay close attention to the age, clinical complications, the factor scores of GCS the occurrence of delayed intracranial hemorrhage prevention after craniocerebral trauma.