[1]郭 旭、孙佩欣、张 烨、姚 冰、朴浩哲,赵红宇.单纯颅脑损伤病人凝血功能异常的危险因素[J].临床神经外科杂志,2019,16(04):410-412.[doi:10.13798/j.issn.1009-153X.2019.07.009]
 GUO Xu,ZHAO Hong-yu,SUN Pei-xin,et al.Risk factors of coagulation abnormality and its relationship with prognosis in patients with simple craniocerebral injury[J].Journal of Clinical Neurosurgery,2019,16(04):410-412.[doi:10.13798/j.issn.1009-153X.2019.07.009]
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单纯颅脑损伤病人凝血功能异常的危险因素()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年04期
页码:
410-412
栏目:
论著
出版日期:
2019-08-15

文章信息/Info

Title:
Risk factors of coagulation abnormality and its relationship with prognosis in patients with simple craniocerebral injury
文章编号:
1009-153X(2019)07-0410-03
作者:
郭 旭、孙佩欣、张 烨、姚 冰、朴浩哲赵红宇
110042 沈阳,辽宁省肿瘤医院神经外科;110004 沈阳,中国医科大学附属盛京医院神经外科
Author(s):
GUO Xu1 ZHAO Hong-yu2 SUN Pei-xin1 ZHANG Ye1 YAO Bing1 PIAO Hao-zhe1.
1. Department of Neurosurgery, Cancer Hospital, China Medical University and Liaoning Provincial Cancer Hospital, Shenyang 110042, China; 2. Department of Neurosurgery, Shengjing Hospital, China Medical University, Shenyang 110004, China
关键词:
颅脑损伤凝血功能异常危险因素预后
Keywords:
Craniocerebral injury Coagulation abnormality Risk factor Prognosis
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2019.07.009
文献标志码:
A
摘要:
目的 探讨单纯颅脑损伤病人凝血功能异常的危险因素。方法 回顾性分析2013年8月~2018年5月收治的212例单纯颅脑损伤的临床资料。采用多因素Logistic回归分析检验凝血功能异常的危险因素。结果 212例中,发生凝血功能障碍42例,发生率为19.8%。170例未发生凝血功能障碍。多因素Logistic回归分析结果显示,年龄>55岁、入院时GCS评分低、AIS评分高、头颅CT复查出现血肿增大是颅脑损伤后凝血功能异常的独立危险因素(P<0.05)。出院后随访4~8个月,平均(6.25±1.43)个月;凝血功能异常病人GOS评分[(3.72±0.92)分]明显低于凝血功能正常病人[(4.28±0.66)分;P<0.05]。结论 单纯颅脑损伤病人凝血功能异常的危险因素很多,凝血功能异常影响病人预后,建议临床采取针对性的干预措施,以改善病人预后。
Abstract:
Objective To explore the risk factors of coagulation abnormality and its relationship with the prognosis in the patients with simple craniocerebral injury. Methods The clinical data of 212 patients with simple craniocerebral injury treated from August, 2013 to May, 2018 were analyzed retrospectively. Of 212 patients, 42 had coagulation abnormality and 170 not. The risk factors related to coagulation abnormality were statistically analyzed, and the prognoses were compared between both the groups. Results The dichotomous variables logistic regression analysis showed that the patient's age and score of head abbreviated injury scale (AIS) were positively correlated with the occurrence of coagulation abnormality and the score of GCS at admission was negatively related with the occurrence of coagulation abnormality (P<0.05).The enlargement of intracranial hematoma on CT image strongly suggested the occurrence of coagulation abnormality in the patients with simple craniocerebral injury. The following up from 4 to 8 months after the injury showed that the GOS score was significantly lower in the patients with coagulation abnormality than that in the patients without coagulation abnormality (P<0.01). Conclusions The risk factors related to the coagulation abnormality include the elder, low score of GCS at admission, high score of head AIS and enlargement of hematoma on CT image in the patients with simple craniocerebral injury (OR>1). It is suggested that the patient with coagulation abnormality had a worse prognosis compared with the patient without coagulation abnormality after the simple craniocerebral injury.

参考文献/References:

[1] 王连运,王光民. 重型颅脑损伤患者血清高敏C-反应蛋 白、D-二聚体的变化及其意义[J]. 中国临床神经外科杂 志,2014,19(4):209-211. [2] 马 涛. 颅脑损伤后凝血功能障碍的机制及干预措施[J]. 中国临床神经外科杂志,2017,22(8):601-603. [3] 巩 冰,杨明飞. 中型颅脑损伤凝血功能障碍时间窗的研 究[J]. 中华神经外科杂志,2015,31(12):1255-1257. [4] Folkerson LE, Sloan D, Cotton BA, et al. Predicting progres- sive hemorrhagic injury from isolated traumatic brain injury and coagulation [J]. Surgery, 2015, 158(3): 655-661. [5] 赵杏香,陆岚岚,黄 丽,等. 亚低温康复护理对神经外科 危重病人凝血功能与神经功能的影响[J]. 护士进修杂 志,2018,33(9):56-58. [6] 只达石. 颅脑创伤外科学[M]. 北京:人民卫生出版社, 2009. 127-128. [7] 王 松,苏 菲,高海晓. 中重型创伤性颅脑损伤病人凝 血功能变化及对预后的影响[J]. 检验医学与临床,2017, 14(10):1464-1466. [8] 马 涛. 颅脑损伤后凝血功能障碍的机制及干预措施[J]. 中国临床神经外科杂志,2017,22(8):601-603. [9] 叶党华. 中重度颅脑损伤并发外伤性脑梗死与凝血功能 的关系及对病人预后的影响[J]. 中国实用神经疾病杂 志,2016,19(2):85-86. [10] 谢 彬,王洪正,王帅凯,等. 重型颅脑损伤致严重凝血功 能异常病人的危险因素分析[J]. 广东医学,2017,38(2): 48-49. [11] Nakae R, Yokobori S, Takayama Y, et al. Age-related diffe- rences in fibrinolytic parameters in patients with acute traumatic brain injury [J]. Surg Neurol Int, 2017, 8(1): 214- 217. [12] 于鹏涛,刘 暌,宋 杰,等. 多发伤合并中重型颅脑损伤 凝血功能障碍的相关因素分析[J]. 创伤外科杂志,2017, 19(4):270-272. [13] 张 梨,袁贤瑞. 轻中度颅脑损伤后凝血功能变化与手术 预测的关系[J]. 临床神经外科杂志,2016,13(5):374- 376. [14] Xu G, Hu B, Chen G, et al. Analysis of blood trace elements and biochemical indexes levels in severe craniocerebral trauma adults with Glasgow Coma Scale and injury severity score [J]. Biol Trace Elem Res, 2015, 164(2): 192-197. [15] 龚 健,贺安勇,郑 晨,等. 外伤性脑梗死与凝血功能障 碍的关系及其对颅脑损伤病人的预后影响[J]. 安徽医 学,2018,39(3):337-339.

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备注/Memo

备注/Memo:
(2019-02-15收稿,2019-03-13修回) 通讯作者:朴浩哲,E-mail:pzpy@163.com
更新日期/Last Update: 1900-01-01