颅脑损伤患者早期凝血纤溶功能变化与迟发性颅内出血的相关性分析  

Correlation analysis of early coagulation and fibrinolysis changes with delayed intracranial hemor-rhage in patients with craniocerebral injury

作　　者：黄春波[1] 杨瑞生[1] 李庆安[1] 

机构地区：[1]河南省济源市人民医院神经外科,459000

出　　处：《中国实用医刊》2016年第22期64-66,共3页Chinese Journal of Practical Medicine

摘　　要：目的：探讨颅脑损伤患者早期凝血纤溶功能的变化与迟发性颅内出血的相关性。方法随机选取2013年4月至2015年8月单纯颅脑损伤患者83例，根据患者是否出现迟发性血肿分为观察组（迟发性血肿组）27例和对照组（无血肿）56例，对其血小板计数（PLT）、D-二聚体（D-D）、凝血酶时间（TT）、纤维蛋白原（Fg）、活化部分凝血酶原时间（APTT）、凝血酶原时间（PT）及纤维蛋白降解产物（FDP）水平进行检测记录，另选取健康体检者50例作为健康组，对所有入选对象的早期凝血纤溶功能变化情况及其迟发性颅内出血的发生情况进行观察分析。结果观察组患者的 FDP、D-D、PT 水平明显高于对照组患者，其血浆 Fg 水平明显低于后者，差异有统计学意义（P〈0.05）。颅脑损伤组患者的 FDP、D-D、APTT、PT 水平均高于健康组，其 Fg、PLT 水平则明显低于后者，差异有统计学意义（P〈0.05）。结论颅脑损伤患者普遍存在早期凝血纤溶功能变化，其中通过对患者早期凝血纤溶功能指标进行检测，并结合头颅 CT 检查结果，可有效对迟发性颅内出血风险进行评估。Objective To analyze the correlation of early coagulation and fibrinolysis changes with delayed intracranial hemorrhage in patients with craniocerebral injury. Methods Eighty-three patients with simple brain injury from April 2013 to August 2015 were randomly selected according to whether the patients with delayed onset hematoma,and they were divided into observation group（delayed hematoma group,27 cases）and control group（no hematoma,56 cases）. Recorded the platelet count （PLT）,D- dimer（DD）,prothrombin time（TT）,fiber fibrinogen（Fg）,activated partial thromboplas-tin time（APTT）and early prothrombin time（PT）and fibrin degradation products（FDP）level detec-tion. The other 50 cases of healthy people were selected as healthy group. Observed and analyzed the early coagulation and fibrinolysis changes and occurrence of delayed intracranial hemorrhage of the two groups. Results The FDP,D-D,PT levels of observation group were significantly higher than those of control group,the plasma Fg levels was significantly lower than those of control group,the difference was significant（P〈 0. 05）. The FDP,D-D,APTT,PT of craniocerebral injury group were higher than those of healthy group,the Fg,PLT level of brain injury group were significantly lower than those of healthy group,the differences were significant（ P〈 0. 05）. Conclusions The early coagulation changes in brain injury patients is ubiquitous. Detecting the early coagulation and fibrinolysis combined with cranial CT examination results can in order to evaluate the risk of delayed intracranial hemorrhage.

关 键 词：颅脑损伤 迟发性颅内出血 早期凝血纤溶功能 相关性 

分 类 号：R651.15[医药卫生—外科学]