不同程度颅脑损伤患者凝血功能障碍发生情况及对患者预后的影响

The occurrence of coagulation disorder in patients with variant degrees of craniocerebral injury and its influence on the prognosis of the patients

目的探究不同程度颅脑损伤患者凝血功能障碍发生情况及对患者预后的影响。方法选取2017年9月至2018年8月我院收治的颅脑损伤患者75例,按照患者颅脑损伤程度分为轻度组、中度组和重度组,每组各25例,所有患者均接受3个月治疗,比较治疗后三组患者凝血功能指标水平及预后情况。结果治疗后,重度组PT为(16.24±2.73)s、APTT为(45.67±2.39)s、TT为(16.15±1.22)s,长于中度组[(15.55±2.52)s、(38.55±2.82)s、(15.65±0.82)s]和轻度组[(11.61±2.13)s、(31.12±1.54)s、(15.35±0.58)s],差异有统计学意义(P<0.05);治疗后,重度组FIB水平为(1.17±0.33)g/L,低于重度组和轻度组,差异有统计学意义(P<0.05);治疗后,重度组GCS评分为(10.62±1.72)分,低于轻度组和中度组[(14.21±1.93)分、(12.70±1.63)分],重度组ADL评分为(65.31±2.83)分,低于轻度组和中度组[(91.25±3.21)分、(82.62±2.54)分],差异均有统计学意义(P<0.05);重度组出现继发脑损伤14例,明显高于中度组的9例和轻度组的3例,差异有统计学意义(P<0.05)。结论患者颅脑损伤程度可依据PT和APTT水平进行判定,凝血功能异常程度越大患者颅脑损伤的预后能力越差,借助凝血功能障碍来判断患者颅脑损伤程度的方式值得临床推广应用。

Objective To investigate the occurrence of coagulation disorder in patients with variant degrees of craniocerebral injury and its influence on the prognosis of the patients.Methods A total of 75 patients with craniocerebral injury admitted to and treated in our hospital from September 2017 to August 2018 were selected.According to the degree of craniocerebral injury,the patients were divided into mild group,moderate group and severe group,25 cases in each group.All patients were treated for 3 months.The coagulation function and prognosis of the three groups were compared after treatment.Results After treatment,PT,APTT and TT in severe group were(16.24±2.73)s,(45.67±2.39)s and(16.15±1.22)s,which were longer than those in moderate group([15.55±2.52]s,[38.55±2.82]s,[15.65±0.82]s)and mild group([11.61±2.13]s,[31.12±1.54]s,[15.35±0.58]s),and the difference was statistically significant(P<0.05).After treatment,the FIB level of severe group was(1.17±0.33)g/L,which was lower than that of severe group and mild group(P<0.05).After treatment,the GCS score of severe group was(10.62±1.72)points,which was lower than that of mild group and moderate group([14.21±1.93]points,[12.70±1.63]points),and the ADL score of severe group was(65.31±2.38)points,which was lower than that of mild group and moderate group([91.25±3.21]points,[82.62±2.54]points),and the difference was statistically significant(P<0.05).There were 14 cases of secondary brain injury in severe group,which were significantly higher than 9 cases in moderate group and 3 cases in mild group(P<0.05).Conclusion The degree of craniocerebral injury in patients can be determined according to the PT and APTT levels.The greater the degree of coagulation disorder is,the poorer the prognosis ability of the patients with craniocerebral injury is.The method of judging the degree of craniocerebral injury in patients through coagulation disorder is worthy of clinical promotion and application.