轻中度颅脑损伤后凝血功能变化与手术预测的关系  

Correlation of coagulation changesand surgical predicted of mild to moderate traumatic brain injury

作　　者：张梨[1,2] 袁贤瑞[1] 

机构地区：[1]中南大学湘雅医院神经外科,长沙410008 [2]华容县人民医院神经外科

出　　处：《临床神经外科杂志》2016年第5期374-376,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨轻中度颅脑损伤（TBI）后凝血功能变化与手术预测之间的关系。方法 2013年10月～2015年9月在我院治疗的55例轻中度TBI患者,根据住院期间是否需要开颅手术分为手术组（8例）和非手术组（47例）。比较两组患者入院时血小板计数、纤维蛋白降解产物（FDP）、国际标准化比值（INR）、部分凝血活酶时间（APTT）、纤维蛋白原和D-二聚体之间的差异。结果手术组患者凝血功能明显低于非手术组,其中APTT、FDP和D二聚体明显低于非手术组（P〈0.05～0.01）;而两组血小板计数、INR和纤维蛋白原比较,差异无统计学意义（均P〉0.05）。结论轻中度TBI患者凝血功能障碍和异常纤维蛋白原溶解与手术预测相关;临床应将其用于预测TBI患者的手术需要及预后。Objective To explore the correlation of coagulation changes and surgical prediction of mild to moderate traumatic brain injury（ TBI）. Methods From October 2013 to September 2015,55 Patients with mild to moderate TBI were divided into surgery group（ 8 cases） and non-surgery group（ 47 cases） according to whether or not underwent craniotomy in our hospital. The differences of platelet count, fibrin degradation products（ FDP）,international normalized ratio（ INR）,activated partial thromboplastin time（ APTT）,fibrinogen and D-dimer were compared between two groups on admission. Results The coagulation function of surgery group was significantly lower than non-surgery group,which APTT,FDP and D-dimer less than non-surgery group（ P〈 0. 05--0. 01）.There was no significant difference in platelet count,INR and fibrinogen（ all P〉0. 05）. Conclusion Coagulation dysfunction and abnormal fibrinogenolytic associated with disease progression in mild to moderate TBI. They should be recommended for predicting surgery demands and prognosis.

关 键 词：颅脑损伤 凝血功能 预后 

分 类 号：R651.1[医药卫生—外科学]