急性颅脑损伤后的纤溶变化及其临床意义  

The clinical significance and changes of fibrinolysis after acute head injury.

作　　者：王安生[1] 李迎山[1] 韩建林[1] 

机构地区：[1]陕西省西安市中心医院神经外科,710003

出　　处：《中国综合临床》2003年第1期65-66,共2页Clinical Medicine of China

摘　　要：目的探讨急性颅脑损伤后的纤溶变化及其临床意义。方法动态观察 75例急性颅脑损伤患者血浆中的纤溶酶、纤溶酶原激活剂抑制和D 二聚体 ,结合临床进行不同的分组比较分析。结果伤后 2 4小时内 3项纤溶指标的检测结果与对照组、伤后 7天、14天比较均有非常显著的差异 ;按伤情轻重、预后以及有无迟发颅内出血进行分组比较 ,差异均具有统计学意义 ;D 二聚体的异常率最高。结论急性颅脑损伤的早期可出现明显的纤溶异常 ,它对判断脑实质损伤程度及迟发颅内出血的发生具有参考价值 ,当D 二聚体血浆水平≥ 8mg/L时 。Objective To study the clinical significance and changes of fibrinolysis after acute head injury.Methods Fibrinolysin,plasminogen activator inhibitor(PAI) and D dimer in plasma of 75 patients with acute head injury were dynamically observed.According to the clinical situation,the patients were divided into groups and analyzed.Results The fibrinolytic indexes(fibrinolysin,PAI and D dimer) at 24 h after injury were significantly different from that in control group and at 7 d and 14 d in patients.According to the injury degree,prognosis and delayed intracranial bleeding,the fibrinolytic indexes were divided and compared,showing statistical significance.The abnormal rate of D dimer was the highest.Conclusion Fibrinolysis disorder,which happens in early stage after head injury,can help to judge the degree of brain parenchyma injury and delayed intracranial bleeding.If D dimer is or over 8 mg/L,it can be a mark of inauspicious prognosis.

关 键 词：急性颅脑损伤 临床意义 D-二聚体 纤溶异常 预后 

分 类 号：R651.15[医药卫生—外科学]