论文部分内容阅读
目的研究凝血指标能否协助判断颅脑损伤颅内出血稳定与否,是否可作为病情变化的重要的临床客观依据。方法回顾性分析81例颅脑损伤患者的凝血指标的变化,结合GCS评分及头颅CT结果 ,判断凝血指标异常与出血增多的关系。结果在81例中,有15例经复查头颅CT发现出血增多,66例出血未增多,出血增多组均有3项以上凝血指标增高,其中APTT及D-二聚体均增高;出血未增多组凝血指标基本正常,一般只有D-二聚体增高,仅有6例出现2项增高,未见3项以上增高。结论凝血指标尤其是PT秒值、PT-INR、APTT、纤维蛋白原、D-二聚体这5项指标的异常对于判断颅脑损伤出血增多与否是有一定意义的,尤其3项以上增高,应高度怀疑出血可能增多。凝血指标可以作为协助判断外伤性颅内出血稳定与否的临床指标之一。
Objective To investigate whether coagulation index can help determine the stability of intracranial hemorrhage in patients with craniocerebral injury, and whether it can be used as an important clinical objective basis for the change of disease. Methods A retrospective analysis of 81 cases of traumatic brain injury in patients with coagulation changes, combined GCS score and cranial CT results to determine the relationship between coagulation abnormalities and increased bleeding. Results In 81 cases, 15 cases were examined by skull CT and found that hemorrhage increased, 66 cases did not increase hemorrhage, 3 cases had more blood coagulation index, in which APTT and D-dimer were higher than those without hemorrhage Coagulation index was normal, generally only D-dimer increased, only 6 cases appeared 2 increased, no more than 3 increased. Conclusion The coagulation indexes, especially the PT seconds, PT-INR, APTT, fibrinogen and D-dimer are useful for judging the increase of hemorrhage in brain injury, especially for more than 3 items , Should be highly suspected bleeding may increase. Blood coagulation index can be used as a clinical indicator to help determine the stability of traumatic intracranial hemorrhage.