儿童颅脑外伤术后凝血功能障碍的影响因素分析  

Analysis of influencing factors of coagulation dysfunction after craniocerebral trauma in children

作　　者：王超 高铮铮 王芳[1] 胡璟[1] 张建敏[1] Wang Chao;Gao Zhengzheng;Wang Fang;Hu Jing;Zhang Jianmin(Department of Anesthesiology,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院麻醉科、国家儿童医学中心,100045

出　　处：《北京医学》2023年第5期412-416,共5页Beijing Medical Journal

摘　　要：目的探讨儿童创伤性硬膜外血肿清除术后发生凝血功能障碍的影响因素。方法选取2016年2月至2022年6月在首都医科大学附属北京儿童医院行硬膜外血肿清除术的93例患儿,根据术后是否发生凝血功能障碍分为正常组和障碍组,采用多因素logistic回归方程分析创伤性硬膜外血肿清除术后凝血功能障碍的影响因素。结果93例患儿中,男60例,女33例,年龄0~15岁,平均(4.4±3.7)岁,术后发生凝血功能障碍33例,发生率35.48%。多因素logis⁃tic回归分析结果显示,术前的HCT越低(OR=0.898,95%CI:0.831~0.971,P=0.007)、PLT越低(OR=0.984,95%CI:0.973~0.994,P=0.003)和PT越长(OR=4.524,95%CI:1.956~10.467,P=0.000)的患儿,创伤性硬膜外血肿清除术后发生凝血功能障碍的风险越大。结论创伤性硬膜外血肿清除术后患儿发生凝血功能障碍较常见,术前HCT和PLT降低、PT延长是患儿术后凝血功能障碍产生的危险因素。Objective To explore the influencing factors of coagulation dysfunction after the removal of traumatic epidural hematoma in children.Methods A total of 93 children who underwent epidural hematoma removal in Beijing Children's Hospital,Capital Medical University from February 2016 to June 2022 were selected,and were divided into normal group and dysfunction group according to whether coagulation dysfunction occurred after operation,and the influencing factors of coagulation dysfunction after traumatic epidural hematoma removal were analyzed by multivariate logistic regression method.Results There were 60 males and 33 females among the 93 children,aged from 0 to 15 years,average age(4.4±3.7)years.including There were 33 cases of coagulation dysfunction after operation,the incidence rate was 35.48%.Multivariate logistic regression analysis showed that the lower the HCT(OR=0.898,95%CI:0.831-0.971,P=0.007)and the lower the PLT(OR=0.984,95%CI:0.973-0.994,P=0.003)and the longer the PT before operation(OR=4.524,95%CI:1.956-10.467,P=0.000),the greater the risk of coagulation dysfunction after traumatic epidural hematoma removal.Conclusions Coagulation dysfunction is common in children after traumatic epidural hematoma removal.The decreased HCT and PLT,the prolonged PT before operation are the risk factors for coagulation dysfunction after operation in children.

关 键 词：创伤性颅脑损伤 硬膜外血肿 凝血功能障碍 儿童 

分 类 号：R726.5[医药卫生—儿科]