创伤性脑损伤后凝血功能障碍机制及预后的研究进展

Advances in the mechanism and prognosis of coagulopathy after traumatic brain injury

凝血功能障碍是创伤性脑损伤(TBI)患者发生不良预后的独立危险因素,目前关于TBI患者伤后凝血功能障碍发生机制的研究多且复杂,可能与组织因子的释放、休克、低血压、血小板功能障碍等有关。TBI患者凝血功能障碍的发生可通过凝血功能实验室检查、血栓弹力图等进行早期识别,防止继发性脑损伤与不良预后的发生。该文总结了目前TBI患者发生凝血功能异常的机制、与不良预后相关性等方面的研究进展,以期为进一步临床研究提供指导。

Researches revealed that coagulopathy was an independent factor of unfavorable outcome in patients with traumatic brain injury(TBI).The proposed mechanism that trigger hemostatic disorders after TBI is still complex and controversial,which may be associated with tissue factor,shock,hypotension,platelet dysfunction.According to coagulation laboratory test and thromboelastogram,we can early identify whether TBI patients are complicated with coagulopathy and prevent the occurrence of secondary brain injury.This article summarizes the current researches about the mechanism of coagulopathy in TBI patients and its correlation with unfavorable prognosis,hoping to provide guidance for further clinical research.