112例颅脑损伤患者凝血功能检测的临床分析  

Clinical analysis of coagulation for 112 patients with traumatic brain injury

作　　者：李钢[1] 曹作为[1] 史克珊[1] 金虎[1] 陈晓东[1] 陈焕雄[1] 林鹏[1] 陈伟明[1] 

机构地区：[1]海南省海口市人民医院,中南大学湘雅医学院附属海口医院神经外科,海南海口570208

出　　处：《海南医学》2008年第11期9-11,共3页Hainan Medical Journal

基　　金：海南省自然科学基金指导项目(编号:80450)

摘　　要：目的观察并分析112例颅脑损伤患者伤后首次凝血功能检测结果与病情、预后的关系。方法采集并分析2004年7月至2006年1月海口市人民医院神经外科收治的112例单纯性颅脑损伤患者入院时凝血常规检查结果,根据患者入院时GCS评分(格拉斯哥昏迷评分)、有否发生继发血肿、有否发生外伤性脑梗塞及GOS评分(格拉斯哥结果评分)进行比较。统计分析采用SPSS11.5软件,P<0.05为差异显著。结果PT(疑血酶原时间)在有无继发性颅内血肿和有无外伤性脑梗塞两种比较时差异显著,APTT(活化部分疑血活酶时间)在有无外伤性脑梗塞比较时差异显著,TT(疑血酶时间)在GCS评分不同的三组间差异显著,Fbg(纤维蛋白原)在GCS评分和有无继发性颅内血肿两种情况比较时差异显著;TT值在GOS评分不同组间比较差异显著,GOS2分、3分、4分、5分组比GOS1分组TT时间短,差异显著;与COS1分组比较,GOS2分、3分、4分、5分组Fbg值明显偏高,差异显著。结论颅脑损伤患者24h内凝血常规指标与颅脑损伤的伤情、预后及并发症等方面有一定关联,因此需进行动态监测出凝血指标,以期能更及时地掌握患者的凝血状况,除此以外还需要进行更具有特异性凝血纤溶指标检测。Objective 112 cases with isolated head injury were analyzed retrospectively in the coagulation assays in order to explore the relationship between blood clotting function and the condition and the prognosis of the patients. Methods .All 112 patients （79 males and 33 females） admitted in Haikou municipal hospital from July 2004 to Jan. 2006. The venous blood samples were obtained from every patients on admission to detect TT,PT,APTT and Fbg respectively. The result was statistically analyzed according to their：. GCS,GOS, have subsequent hematonm or not, have traumatic irffarction or not. We used SPSSI1.5 software package for statistical analysis. Significance was set at P〈0.05. Results 1. PT in both the patients with subsequent hematoma or not and the patients with traumatic infarction or not had significant difference. AFTT in the patients with traumatic infarction or not had significant difference. TT had significant difference in all the different GCS groups. Fbg had significant difference in two conditions： different GCS scores and had subsequent hematoma or not. 2. TT in GOS 1 group prolonged significantly than that in the GOS2,3,4,5 group and Fbg in GOS 1 group was significantly lower than that in GOS2,3,4,5 group. Conclusion The detection about coagulation tests within 24h showed blood-clotting disorder （eoagulopathy） in the acute period post-head injury corresponded with patients＇ condition, outcome and complication. So, it is necessary to monitor continually in order to find the change of the coagnlation of the patients as soon as possible. In addition, more distinctive test about coagulation is beneficial for diagnosis of eoagnlopathy.

关 键 词：颅脑损伤 凝血紊乱 高凝状态 纤溶亢进 

分 类 号：R651.15[医药卫生—外科学]