单纯颅脑损伤病人凝血功能异常的危险因素

Risk factors of coagulation abnormality and its relationship with prognosis in patients with simple craniocerebral injury

目的探讨单纯颅脑损伤病人凝血功能异常的危险因素。方法回顾性分析2013年8月~2018年5月收治的212例单纯颅脑损伤的临床资料。采用多因素Logistic回归分析检验凝血功能异常的危险因素。结果 212例中,发生凝血功能障碍42例,发生率为19.8%。170例未发生凝血功能障碍。多因素Logistic回归分析结果显示,年龄>55岁、入院时GCS评分低、AIS评分高、头颅CT复查出现血肿增大是颅脑损伤后凝血功能异常的独立危险因素(P<0.05)。出院后随访4~8个月,平均(6.25±1.43)个月;凝血功能异常病人GOS评分[(3.72±0.92)分]明显低于凝血功能正常病人[(4.28±0.66)分;P<0.05]。结论单纯颅脑损伤病人凝血功能异常的危险因素很多,凝血功能异常影响病人预后,建议临床采取针对性的干预措施,以改善病人预后。

Objective To explore the risk factors of coagulation abnormality and its relationship with the prognosis in the patients with simple craniocerebral injury. Methods The clinical data of 212 patients with simple craniocerebral injury treated from August,2013 to May, 2018 were analyzed retrospectively. Of 212 patients, 42 had coagulation abnormality and 170 not. The risk factors related to coagulation abnormality were statistically analyzed, and the prognoses were compared between both the groups. Results The dichotomous variables logistic regression analysis showed that the patient’s age and score of head abbreviated injury scale(AIS) were positively correlated with the occurrence of coagulation abnormality and the score of GCS at admission was negatively related with the occurrence of coagulation abnormality(P<0.05).The enlargement of intracranial hematoma on CT image strongly suggested the occurrence of coagulation abnormality in the patients with simple craniocerebral injury. The following up from 4 to 8 months after the injury showed that the GOS score was significantly lower in the patients with coagulation abnormality than that in the patients without coagulation abnormality(P<0.01). Conclusions The risk factors related to the coagulation abnormality include the elder, low score of GCS at admission, high score of head AIS and enlargement of hematoma on CT image in the patients with simple craniocerebral injury(OR>1). It is suggested that the patient with coagulation abnormality had a worse prognosis compared with the patient without coagulation abnormality after the simple craniocerebral injury.