摘要
目的探讨脑颅脑损伤急诊开颅手术前患者的凝血功能与伤情严重程度及预后的相关性。方法选择2013年4月至2014年12月本院收治的颅脑损伤急诊行开颅手术的患者120例,根据格拉斯哥昏迷指数评分(Glasgow Cowa Scale,GCS),将患者分为轻型、中型、重型三组,对比三组之间的凝血功能指标,然后再根据患者在伤后3个月的格拉斯哥预后评分(Glasgow Outcome Scale,GOS),将患者分为预后良好组与预后不良组,对比两组患者质检的凝血功能指标,最后对可能引起颅脑损伤性凝血功能障碍的影响因素分析。结果在本组研究中凝血功能障碍发生率为35.83%;与对照组对比,研究组(A组、B组、C组)的PT、APTT、INR的水平显著升高,差异有统计学意义(Z=-2.878,P=0.003<0.01);并且重型损伤组和中型损伤组的PT、APTT的水平显著高于轻型损伤组,差异有统计学意义(Z=-3.630,P<0.001)。与预后不良组对比,预后良好组患者的PT、APTT、INR的水平均显著降低,差异有统计学意义(P<0.05)。经Spearman相关性分析发现,颅脑损伤患者的PT、APTT、INR水平与其预后具有显著的相关性(P<0.01)。结论颅脑损伤急诊开颅术前凝血功能发生率较高,其中凝血指标PT、APTT、INR的水平对评估患者病情的严重程度及其预后具有重要价值。
Objective To investigate the relationship between the coagulation function and the severity of the injury and the prognosis in patients with traumatic brain injury. Method From April 2013 to December 2014 in our hospital,120 cases adopted emergency craniotomyfortraumatic brain injurywere selected.According to the Glasgow Coma Scale score（GCS）, the patients were divided intothree groups： light,medium and heavy. Thecoagulation parameterswere compared between the three groups.Depending on Glasgow Outcome Scale（GOS） after 3 months,the patients were divided into good prognosis group and poor prognosis group, the coagulation parameters were comparedbetween the two groups.And analysis the factors may cause coagulopathy in brain trauma. Result In this group, the coagulation dysfunction occurrence rate was 35.83%.Compared with the control group, Pt, APTT, INR levels in the study groups（group A, group B, group C） wereincreased, the difference were statistically significant（Z=-2.878, P=0.0030.01）. Pt and APTT levels in the severe group and medium group were significantly higher than those in light group,the difference were statistical significant（Z=-3.630, P〈0.001）. The levels of APTT, INR and PT were significantly decreased in good prognosis group,and the difference was statistically significant（P〈0.05）. Spearman correlation analysis showed that the level of APTT, INR and PT in patients with brain injury had a significant correlation with the prognosis（P〈0.01）. Conclusion The rate of coagulation function in patients with craniocerebral trauma washigh, and the levels of INR, APTT and PT wereimportant toevaluatethe severity and prognosis.
出处
《浙江创伤外科》
2016年第1期9-11,14,共4页
Zhejiang Journal of Traumatic Surgery
关键词
颅脑损伤
急诊
凝血功能
预后
Craniocerebral trauma
Emergency
Coagulation function
Prognosis
