急性颅脑损伤凝血功能异常的临床研究

目的探讨急性颅脑损伤患者的凝血功能变化特点以及与颅脑损伤严重程度、预后的关系。方法(1)将168例急性颅脑外伤患者分为轻、中、重型3组,测定病人入院当时和发病后24h的血浆凝血酶原时间(PT),活化部分凝血活酶时间(APTT),纤维蛋白降解产物(FDP),d-二聚体(D-dimer),血小板(BPC)值,并与45例健康对照组比较。(2)治疗1个月后将168例分为GOS4~5分和3~1分两组,比较两组PT、APTT、FDP、D-dimer、BPC值。结果(1)各型颅脑损伤与对照组比较,PT、APTT、FDP、D-dimer均有显著差异。(2)各型颅脑损伤中PT、APTT、FDP、D-dimer均有异常,随着伤情加重PT、APTT、FDP、D-dimer均升高。(3)治疗1个月后GOS1~3分组较GOS4~5分组PT、APTT、FDP、D-dimer有明显差异。结论急性颅脑损伤后存在凝血功能异常,且与颅脑损伤程度相关,可为判断急性颅脑损伤预后提供依据。

Clinical investigation of blood coagulation and fibrinolysin in acute craniocerebral injuries

Objective To investigate the characteristics of blood coagulation and fibrinolysin in acute craniocerebral injuries and to evaluate their effect on diagnosis.Methods(1)To divide 168 patients into three groups according to the disease severity of acute craniocerebral injuries.To detect the levels of PT,APTT),FDP,D-diner and DPC of patients twice during 24h after the patients registered the hospital,and to compare the levels among the three groups as well as the healthy group.(2)To divide 168 patients into two groups,Gos4-5 and Gos3-1 after one-month cure,then to compare the levels of PT,APTT,FDP,D-diner and BPC between them.Results PT,APTT,FDP,D-diner and BPC are all abnormal in all kinds of acute craniocerebral injuries.The more the severity of head injury,the higher the levels of PT,APTT,FDP,D-diner and BPC are.(3) Gos1-3`s levels of PT,APTT,FDP,D-diner and BPC in group Gos 1-3 are higher than those in group Gos4-5 after one-month treatment.Conclusion(1) The levels of PT,APTT,FDP,D-diner are quite different between the healthy group and the group suffered from acute craniocerebral injury.The patients with acute craniocerebral injuries have the disturbances of blood coagulation and fibrinolysin,which is related to the severity of head injury.PT,APTT,FDP,D-diner Could be an indexes to judge the prognosis of patients suffered from craniocerebral injury.