227例颅脑创伤患者凝血功能的动态变化及其临床意义  

Incidence of the coagulation function abnormality in patients with traumatic brain injury and its significances

作　　者：赵元元[1] 连玉峰 杨开创[1] 楼林[1] 卢刚[1] 

机构地区：[1]浙江省人民医院神经外科,杭州310014

出　　处：《浙江创伤外科》2014年第6期883-885,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的观察和研究各类颅脑创伤患者凝血功能异常的发生率及其临床意义。方法对本院2013年收治的227例单纯性颅脑创伤患者按损伤的性质和类型进行分组并分别检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)等凝血功能指标的动态变化。结果 227例患者中,颅脑外伤后24小时内凝血功能指标PT、APTT、TT和FIB检测值异常的发生率分别为11%、71.4%、34.4%和21.2%;颅脑外伤后72小时PT、APTT、TT和FIB检测值异常的发生率明显降至2.6%、33.9%、5.7%和17.6%。在各类颅脑创伤中,急性硬膜下血肿患者24小时、48小时、72小时和7天时间段凝血功能指标PT、APTT、TT和FIB检测值异常的发生率均明显高于其他颅脑外伤患者,差异有统计学意义(P<0.05)。结论颅脑创伤患者伤后24小时内即可出现凝血功能异常,72小时后凝血功能异常的发生率明显降低;颅脑创伤患者凝血功能异常的发生率和持续时间可能与颅脑创伤的性质和类型有关。Objective To investigate the Incidence of coagulation function abnormality in patients with traumatic brain injury and its signifi-cances. Methods The blood coagulation data of 227 patients with simple traumatic brain injure classified based on traumatic character and type were detected. Results In selected 227 cases with traumatic brain injury, the incidences of coagulation abnormality defined as PT, APTT, TT and FIB were 11%, 71.4%, 34.4%and 21.2%detected within 24hours. 72 hours later, the incidences of these indexes were markedly decreased into 2.6%, 33.9%, 5.7% and 17.6% after brain trauma. The incidences of coagulation abnormality defined as PT, APTT, TT and FIB detected at the time of 24-huor, 48-huor, 72-huor and 7-day were significantly higher in patients with acute subdural hematoma than that in patients suffering with other type of traumatic brain injury （P〈0.05）. Conclusion Coagulation abnormality caused by traumatic brain injury occurred within 24 hours and the inci-dence of coagulation abnormality was decreased significantly after 72 hours after brain trauma. The sustained duration of coagulation abnormality may correlate to the character and type of traumatic brain injury.

关 键 词：凝血功能 颅脑外伤 发生率 

分 类 号：R651.1[医药卫生—外科学]