樊煒 1 , 辛泉 2
  • 1.簡(jiǎn)陽(yáng)人民醫(yī)院腦外科,四川簡(jiǎn)陽(yáng) 641400;2.成都市第二人民醫(yī)院腦外科,四川成都 610072;

目的:探討腦損傷患者凝血功能水平與顱腦損傷傷情轉(zhuǎn)歸的相關(guān)性。方法:收集70例顱腦損傷患者的臨床資料,傷者抽取靜脈血2 mL,進(jìn)行凝血功能檢測(cè),分析結(jié)果與臨床資料等分別采用SPSS 11.5軟件進(jìn)行χ2檢驗(yàn)和logistic回歸分析。結(jié)果:在13例凝血功能異常患者中有5例(38%)傷情加重(較入院時(shí)腦內(nèi)血腫體積增大,遲發(fā)性血腫等),明顯高于凝血功能正常而傷情加重者(12%,P lt;0.05);單因素和多因素logistic回歸分析提示凝血功能異常時(shí)腦損傷傷情加重的危險(xiǎn)因素。結(jié)論:腦創(chuàng)傷后凝血功能異常時(shí)顱腦損傷患者傷情加重的危險(xiǎn)因素。

引用本文： 樊煒,辛泉. 腦損傷患者凝血功能水平和預(yù)后的相關(guān)性探討. 華西醫(yī)學(xué), 2009, 24(4): 809-811. doi: 復(fù)制

1. TALVING P, BENFIELD R, HADJIZACHARIA P, et al. Coagulopathy in severe traumatic brain injury: a prospective study[J]. J Trauma,2009,66(1):55-62..
2. 李銀平.急性顱腦損傷后亞低溫治療無(wú)臨床價(jià)值[J].中國(guó)危重病急救醫(yī)學(xué),2001,13(8):459..
3. DRUSKIN M S, DRIJANSK R. Afibrinogenemia with severe head trauma[J]. J Am Med Association,1972,219(6):755..
4. 譚宗德,徐延森,程新福,等.腦挫裂傷的臨床分型與治療探討[J].中國(guó)臨床神經(jīng)外科雜志,2003,8(1):16-11..
5. 靳懷明,李浩,李志華.顱腦損傷術(shù)后遲發(fā)性腦缺血性損害及其相關(guān)性因素[J].河南外科學(xué)雜志,2005,11(1):5-6..
6. VANDER A J, MOORE LG, BREWER G, et al. Effects of high altitude on plasma concentrations of testosterone and pituitary gonadotropins in man[J]. Aviat Space Environ Med,1978,49(2):356-357..
7. SCHERER R U, SPANGEBERG P. Procoagulant actibity in patients with isolated severe head trauma[J]. J Crit Care Med,1998,26(1):149-156..
8. GANDO S, NANZAKI S, KEMMOTSU O. Coagulofibrinolytic changes after head injury are not different from those in trauma patients without head injury[J]. J Trauma,1999,46(3):1070-1076..
9. MAY A K, YOUNG JS, BUTLER K, et al. Coagulopathy in severe closed head injury: is empiric therapy warranted?[J] J Am Surg,1997,63(2):233-236..
10. SELLADURAI B M, VICKNESWARAN M, DURAISAMY S, et al. Coagulopathy in acute head injury: a study of its role as a prognostic indicator[J]. J Br J Neurosurg,1997,11:398-404..
11. 李鋼,柯以銓.腦損傷后凝血功能改變的研究進(jìn)展[J].中華創(chuàng)傷雜志,2003,19(1):57-59..
12. TAKAHASHI H, URANO T, TAKADA Y, et al. Fibrinolytic parameters as an admission prognestic marker of head injury in patients who talk and deteriorate[J]. J Neurosurg,1997,86(5):768-772.[13]高李貴,劉重霄,王卉芳,等.顱腦損傷急性期血漿凝血因子水平的變化[J].西安交通大學(xué)學(xué)報(bào)醫(yī)學(xué)版,2003,24(5):505-506..
13. TAKANASHI Y, SHINONAGA M, KOH E, et al. Coagulation disorders as early predictor of brain injury [J]. No To Shinkei,1996,48(11):1009-1013..
14. GRENANDER A,BREDBACKA S,RYDVALL A,et al.Antithrombin treatment in patients with traumatic brain injury: a pilot study[J]. J Neurosurg Anesthesiol,2001,13(1):49-56..
15. VAN’T VEER C, MANN K G. The regulation of the factor Ⅶ-dependent coagulation pathway: rationale for the effectiveness of recombinant factor Ⅶ a in refractory bleeding disorders[J]. Semin Thromb Hemost,2000,26(4):367-372..
16. ALLEN G A, HOFFMAN M, ROBERTS H R, et al. Recombinant activated factor Ⅶ: its mechanism of action and role in the control of hemorrhage. Can J Anaesth,2002,49:S7-S14..
17. DUTTON R P, MCCUNN M, HYDER M, et al. Factor Ⅶa for correction of craumatic coagulopathy[J]. J Trauma,2004,57(4):709-718.
  1. 1. TALVING P, BENFIELD R, HADJIZACHARIA P, et al. Coagulopathy in severe traumatic brain injury: a prospective study[J]. J Trauma,2009,66(1):55-62..
  2. 2. 李銀平.急性顱腦損傷后亞低溫治療無(wú)臨床價(jià)值[J].中國(guó)危重病急救醫(yī)學(xué),2001,13(8):459..
  3. 3. DRUSKIN M S, DRIJANSK R. Afibrinogenemia with severe head trauma[J]. J Am Med Association,1972,219(6):755..
  4. 4. 譚宗德,徐延森,程新福,等.腦挫裂傷的臨床分型與治療探討[J].中國(guó)臨床神經(jīng)外科雜志,2003,8(1):16-11..
  5. 5. 靳懷明,李浩,李志華.顱腦損傷術(shù)后遲發(fā)性腦缺血性損害及其相關(guān)性因素[J].河南外科學(xué)雜志,2005,11(1):5-6..
  6. 6. VANDER A J, MOORE LG, BREWER G, et al. Effects of high altitude on plasma concentrations of testosterone and pituitary gonadotropins in man[J]. Aviat Space Environ Med,1978,49(2):356-357..
  7. 7. SCHERER R U, SPANGEBERG P. Procoagulant actibity in patients with isolated severe head trauma[J]. J Crit Care Med,1998,26(1):149-156..
  8. 8. GANDO S, NANZAKI S, KEMMOTSU O. Coagulofibrinolytic changes after head injury are not different from those in trauma patients without head injury[J]. J Trauma,1999,46(3):1070-1076..
  9. 9. MAY A K, YOUNG JS, BUTLER K, et al. Coagulopathy in severe closed head injury: is empiric therapy warranted?[J] J Am Surg,1997,63(2):233-236..
  10. 10. SELLADURAI B M, VICKNESWARAN M, DURAISAMY S, et al. Coagulopathy in acute head injury: a study of its role as a prognostic indicator[J]. J Br J Neurosurg,1997,11:398-404..
  11. 11. 李鋼,柯以銓.腦損傷后凝血功能改變的研究進(jìn)展[J].中華創(chuàng)傷雜志,2003,19(1):57-59..
  12. 12. TAKAHASHI H, URANO T, TAKADA Y, et al. Fibrinolytic parameters as an admission prognestic marker of head injury in patients who talk and deteriorate[J]. J Neurosurg,1997,86(5):768-772.[13]高李貴,劉重霄,王卉芳,等.顱腦損傷急性期血漿凝血因子水平的變化[J].西安交通大學(xué)學(xué)報(bào)醫(yī)學(xué)版,2003,24(5):505-506..
  13. 13. TAKANASHI Y, SHINONAGA M, KOH E, et al. Coagulation disorders as early predictor of brain injury [J]. No To Shinkei,1996,48(11):1009-1013..
  14. 14. GRENANDER A,BREDBACKA S,RYDVALL A,et al.Antithrombin treatment in patients with traumatic brain injury: a pilot study[J]. J Neurosurg Anesthesiol,2001,13(1):49-56..
  15. 15. VAN’T VEER C, MANN K G. The regulation of the factor Ⅶ-dependent coagulation pathway: rationale for the effectiveness of recombinant factor Ⅶ a in refractory bleeding disorders[J]. Semin Thromb Hemost,2000,26(4):367-372..
  16. 16. ALLEN G A, HOFFMAN M, ROBERTS H R, et al. Recombinant activated factor Ⅶ: its mechanism of action and role in the control of hemorrhage. Can J Anaesth,2002,49:S7-S14..
  17. 17. DUTTON R P, MCCUNN M, HYDER M, et al. Factor Ⅶa for correction of craumatic coagulopathy[J]. J Trauma,2004,57(4):709-718.