外伤性迟发颅内出血的相关因素及其与凝血异常的关系

摘要

Objective To analyze the relevant factors of traumatic delayed intracranial hem-orrhage and its relationships with abnormal coagulation.Methods According to intracranial hemor-rhage condition,236 patients with craniocerebral trauma were divided into delayed hemorrhage group and non-delayed hemorrhage group.Routine coagulation indicators 2~12 hours after hospital admission were compared between two groups,including prothrombin time (PT),thrombin time (TT),fibrinogen (FIB),blood platelet count (PLT),activated partial thrombin time (APTT) and prothrombin international normalized ratio (INR),and the relevant risk factors of traumatic de-layed intracranial hemorrhage were analyzed as well.Results PT,TT,APTT and INR in delayed hemorrhage group were significantly longer and higher than non-delayed hemorrhage group,but PLT was lower than non-delayed hemorrhage group.The incidence rate of delayed intracranial hem-orrhage increased when abnormal coagulation indexes ≥2 items.Gender,presence or absence of complications,GCS scores and abnormal coagulation function were closely related to delayed in-tracranial hemorrhage.Conclusion Main risk factors of delayed intracranial hemorrhage are gender, presence or absence of complications,GCS scores and abnormal coagulation function.When abnor-mal coagulation indexes ≥2 items,it is more likely to cause delayed intracranial hemorrhage.%目的：分析外伤性迟发颅内出血的相关因素及其与凝血异常的关系。方法将236例颅脑外伤患者根据颅内出血情况分为迟发出血组与非迟发出血组。比较2组入院后2～12 h 的常规凝血指标，包括凝血酶原时间（PT）、凝血酶时间（TT）、纤维蛋白原（FIB）、血小板计数（PLT）、活化部分凝血活酶时间（APTT）及凝血酶原国际标准化比率（INR），并分析外伤性迟发颅内出血的相关危险因素及其与凝血异常的关系。结果迟发出血组患者 PT、TT、APTT 及 INR 均显著长于或高于非迟发出血组，而 PLT 明显低于非迟发出血组，差异有统计学意义；当凝血指标异常≥2项时，迟发颅内出血的发生率显著升高。性别、有无并发症、GCS 评分及凝血异常与迟发颅内出血明显相关。结论性别、有无并发症、GCS 评分及凝血异常是引发迟发颅内出血的主要危险因素，且当凝血指标异常≥2项时，更易导致迟发颅内出血。