[1]徐孝敬,陈上上,文强国,等.颅脑损伤患者血栓弹力图试验指标变化的分析[J].临床神经外科杂志,2018,15(06):463-466.[doi:10.3969/j.issn.1672-7770.2018.06.016]
 XU Xiao-jing,CHEN Shang-shang,WEN Qiang-guo,et al.Analysis on changes of thrombelastography test index in patients with traumatic brain injury[J].Journal of Clinical Neurosurgery,2018,15(06):463-466.[doi:10.3969/j.issn.1672-7770.2018.06.016]
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颅脑损伤患者血栓弹力图试验指标变化的分析()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
15
期数:
2018年06期
页码:
463-466
栏目:
临床研究
出版日期:
2018-12-15

文章信息/Info

Title:
Analysis on changes of thrombelastography test index in patients with traumatic brain injury
作者:
徐孝敬陈上上文强国汤志钡章剑
325800 温州,苍南县人民医院神经外科
Author(s):
XU Xiao-jingCHEN Shang-shangWEN Qiang-guoet al.
Department of Neurosurgery,The People’s Hospital Cangnan County,Wenzhou 325800,China
关键词:
颅脑损伤血栓弹力图凝血功能
Keywords:
traumatic brain injurythrombelastographyblood coagulation function
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2018.06.016
文献标志码:
D
摘要:
【摘要】目的探讨颅脑损伤(TBI)患者血栓弹力图(TEG)试验指标变化,以期指导颅脑损伤的诊疗和预后。方法选择2017年3月至2018年1月苍南县人民医院收治的90例颅脑损伤患者为对象,按照格拉斯哥昏迷量表(GCS)评分分为重型组(27例)、中型组(35例)和轻型组(28例);并选择同期30例健康体检者为对照组。所有患者和对照者采用TEG检查反应时间(R值)、凝固时间(K值)、血栓最大幅度(Ma)和凝固角(α),检查传统凝血功能指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fib)。比较其与患者病情及预后的关系。结果颅脑损伤组患者的R值、K值、PT和APTT显著高于对照组,而Ma、α和Fib显著低于对照组,差异均有统计学意义(均P<0.001)。重型组和中型组的K值、PT和APTT显著高于轻型组,而Ma、α和Fib显著低于轻型组,重型组R值、K值、PT和APTT显著高于中型组,Ma、α和Fib显著低于中型组,差异均有统计学意义(P<0.05~0.001)。治疗后24 h、72 h和168 h,颅脑损伤组患者的R值、K值、PT和APTT显著低于治疗前,而Ma、α和Fib显著高于治疗前,差异均有统计学意义(均P<0.001)。相关性分析显示,R值、K值、Ma和α均与颅脑损伤密切相关,R值和K值与PT、APTT和Fib正相关,Ma和α与PT、APTT和Fib负相关,且具有较好的一致性,差异均有统计学意义(均P<0.05)。结论TEG试验指标的变化可以较好的反映颅脑损伤患者的凝血状态,对指导颅脑损伤的诊断和预后具有重要意义。
Abstract:
Abstract:ObjectiveTo investigate the changes of thrombelastography (TEG) test index in patients with traumatic brain injury (TBI),in order to guide the diagnosis and treatment and prognosis of TBI.Methods90 patients with TBI admitted in our hospital from March 2017 to January 2018 were divided into heavy group (27 cases),medium group (35 cases) and light group (28 cases) according to the GCS score.30 patients with healthy physical examination were selected as control group at the same period.All patients were TEG check response time (R value),coagulation time (K value),the biggest of thrombosis (Ma) and solidified angle (α),and traditional coagulation function check the indexes of prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (Fib).The relationship of condition and prognosis were compared.ResultsThe value of R,K,PT APTT in research group were significantly higher than the control group,and Ma,αand Fib were significantly lower than the control group,the differences were statistically significant (all P<0.001).The value of R,K,PT APTT in heavy group and medium group were significantly higher than light,and Ma,α and Fib were significantly lower than light group,the value of R,K,PT APTT in heavy group were significantly higher than medium group,and Ma,α and Fib were significantly lower than medium group,the differences were statistically significant (P<0.05-0.001).After 24 h,72 h and 168 h treatment,the value of R,K,PT APTT in research group were significantly lower than before treatment,and Ma,α and Fib were significantly higher than before treatment,the differences was statistically significant (all P<0.001).Correlation analysis showed that the R value,K value,Ma and α were closely associated with TBI,the R and K value were positive related to the PT,APTT and Fib,and Ma and α were Ma negatively related to the PT,APTT and Fib,and had good consistency,the differences were statistically significant (all P<0.05).ConclusionThe changes of thrombelastography test index can better evaluate blood coagulation state in patients with TBI and it is of great significance to guide the diagnosis and prognosis of patients.

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更新日期/Last Update: 1900-01-01