论文部分内容阅读
目的探讨急性颅脑损伤患者凝血与纤溶功能变化与进展性脑内出血(PIH)的关系。方法根据头颅CT的表现,662例颅脑损伤患者分为PIH组(151例)及非PIH组(511例),于伤后6h内、24h和7d动态监测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、国际标准化率(INR)和D-二聚体(D-D)。并取健康体检者作为对照组(50例),分析凝血纤溶变化与PIH的相关性。结果三组PT、Fib和INR在入院时,24h及7d时差异均无统计学意义(P>0.05)。PIH组TT在入院时及24h高于非PIH组及对照组(P<0.05),PIH组APTT在24h上升高于其他两组(P<0.01)。在入院时及24h,PIH组D-D高于非PIH组及对照组(P<0.01)。结论动态监测APTT、TT及D-D变化对预示颅脑外伤后PIH有重要意义。
Objective To investigate the relationship between changes of coagulation and fibrinolysis and progressive intracerebral hemorrhage (PIH) in patients with acute craniocerebral injury. Methods According to the performance of cranial CT, 662 patients with craniocerebral injury were divided into PIH group (151 cases) and non-PIH group (511 cases). Prothrombin time (PT) was dynamically monitored within 6h, 24h and 7d after injury. Activated partial thromboplastin time (APTT), fibrinogen (Fib), thrombin time (TT), international normalized ratio (INR) and D-dimer (DD). Take healthy people as control group (50 cases), analyze the relationship between coagulation and fibrinolysis and PIH. Results There was no significant difference in PT, Fib and INR between the three groups at 24 h and 7 d after admission (P> 0.05). Compared with non-PIH group and control group, TT in PIH group was higher than that in non-PIH group and control group on admission (P <0.05), and APTT in PIH group was higher than that of the other two groups (P <0.01). D-D in PIH group was higher than that in non-PIH group and control group at admission and 24h (P <0.01). Conclusion The dynamic changes of APTT, TT and D-D are important for predicting PIH after traumatic brain injury.