重型颅脑损伤出现弥漫性血管内凝血的相关因素

目的：回顾重型颅脑损伤患者中出现的弥漫性血管内凝血（DIC）的病例，分析DIC发生率以及诱发DIC的因素。方法：按急性重型颅脑损伤诊断标准统计收治的本院神经外科与武警广东总队医院重型颅脑损伤1565例患者，按DIC诊断标准筛选出其中出现DIC的病例。采用Logistic回顾性分析DIC发生率、影响DIC发生的因素。结果：本组重型颅脑损伤1565例，其中，手术1012例，保守治疗553例。总病例中．出现DIC例数19例，其DIC在重型颅脑损伤中发生率为12．14‰，相关因素有复合伤，手术，感染，休克，止血剂的使用，肝功能异常以及凝血和抗凝血指标异常。结论：重型颅脑损伤患者中出现DIC死亡率极高，达63．2％，严重威胁患者健康；对DIC诱因的充分认识，有利早期发现，及时阻断，减少DIC发生。

Clinical analysis on disseminated intravascular coagulation related factors in severe brain injury

Objective：To analyze the incidence of DIC and its causative factors through reviewing cases of severe traumatic brain injury complicated with disseminated intravascular coagulation （DIC）. Methods： Patients were hospitalized based on diagnostic criteria for acute severe brain injury, and DIC cases were screened according to DIC diagnostic criteria. Logistic analysis was applied for retrospective analysis of DIC incidence and DIC-related factors. Result：Of the 1 565 severe head injury cases in this cohort, 1 012 underwent surgery and 553 cases received conservative treatment. Among all patients, 19 experienced DIC, with an incidence of 12. 14 ‰ in severe traumatic brain injury cases. Related factors included complex injuries, surgery, infection, shock, use of haemostatic agents, abnormal liver function, as well as abnormal clotting and anti-coagulation indexes. Conclusion： Mortality in severe head injury patients with DIC can be as high as 63.2% with great threat to patients. Full understanding of DIC-related factors may be useful for early detection and prompt prevention of DIC.