凝血障碍对急性闭合性颅脑创伤预后的临床影响  

Clinical effect of coagulation disorder on prognosis of acute closed craniocerebral traum

作　　者：刘斌 黄洪春 邓科 LIU Bin;HUANG Hongchun;DENG Ke(Department of Neurosurgery,Ruijin People′s Hospital,Jiangxi Province,Ruijin342500,China)

机构地区：[1]江西省瑞金市人民医院神经外科,江西瑞金342500

出　　处：《中国当代医药》2022年第4期97-99,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2020ZSF 686)。

摘　　要：目的探讨凝血障碍对急性闭合性颅脑创伤预后的临床影响。方法回顾性分析2019年1月至12月瑞金市人民医院神经外科收治的80例急性闭合性颅脑创伤患者的临床资料,根据患者是否有凝血障碍分对照组(40例,凝血功能正常)和观察组(40例,凝血功能障碍),比较两组格拉斯哥昏迷指数(GCS)评分、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fg)、凝血酶时间(TT)、进展性颅内出血发生率、预后良好情况。结果术后观察组患者TT、APTT长于对照组,Fg低于对照组,差异有统计学意义(P<0.05),两组PT比较,差异无统计学意义(P>0.05);观察组预后良好率、GCS评分低于对照组,进展性颅内出血发生率高于对照组,差异有统计学意义(P<0.05)。结论急性闭合性颅脑创伤有可能促使患者出现凝血障碍,并且凝血障碍功能障碍越为严重患者预后越差,临床可根据患者凝血障碍评估患者预后。Objective To investigate the clinical effect of coagulation disorder on the prognosis of acute closed craniocerebral trauma.Methods The clinical data of 80 patients with acute closed craniocerebral trauma admitted to the Neurosurgery Department of Ruijin People′s Hospital from January to December 2019 were retrospectively analyzed.According to whether the patients had coagulation disorder,they were divided into control group(40 cases,with normal coagulation function)and observation group(40 cases,with coagulation dysfunction).Glasgow coma index(GCS)score,activated partial thrombin time(APTT),prothrombin time(PT),fibrinogen(Fg),thrombin time(TT),incidence of progressive intracranial hemorrhage and good prognosis were compared between the two groups.Results After operation,TT and APTT in observation group were longer than those of control group,Fg was lower than that of control group,the differences were statistically significant(P<0.05).PT in two groups was not statistically significant(P>0.05).The good prognosis rate and GCS score of the observation group were lower than those of the control group,and the incidence of progressive intracranial hemorrhage was higher than that of the control group,with statistical significances(P<0.05).Conclusion Acute closed craniocerebral trauma may promote the occurrence of coagulopathy in patients,and the more severe the coagulopathy dysfunction is,the worse the prognosis of patients,and the prognosis of patients can be evaluated according to the coagulation disorder.

关 键 词：凝血障碍 闭合性颅脑损伤 预后 格拉斯哥昏迷指数 

分 类 号：R741[医药卫生—神经病学与精神病学]