腦損傷患者凝血功能水平和預后的相關性探討_《華西醫學》

作者：

樊煒 ¹ , 辛泉 ²

1.簡陽人民醫院腦外科,四川簡陽 641400;2.成都市第二人民醫院腦外科,四川成都 610072;

關鍵詞：

腦損傷凝血功能相關性

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目的:探討腦損傷患者凝血功能水平與顱腦損傷傷情轉歸的相關性。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,進行凝血功能檢測,分析結果與臨床資料等分別采用SPSS 11.5軟件進行χ2檢驗和logistic回歸分析。結果:在13例凝血功能異常患者中有5例(38%)傷情加重(較入院時腦內血腫體積增大,遲發性血腫等),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腦損傷傷情加重的危險因素。結論:腦創傷后凝血功能異常時顱腦損傷患者傷情加重的危險因素。

引用本文： 樊煒,辛泉. 腦損傷患者凝血功能水平和預后的相關性探討. 華西醫學, 2009, 24(4): 809-811. doi: 復制

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臨床價值[J].中國危重病急救醫學,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].中國臨床神經外科雜志,2003,8(1):16-11..
5.	靳懷明,李浩,李志華.顱腦損傷術后遲發性腦缺血性損害及其相關性因素[J].河南外科學雜志,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展[J].中華創傷雜志,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].西安交通大學學報醫學版,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. 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臨床價值[J].中國危重病急救醫學,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].中國臨床神經外科雜志,2003,8(1):16-11..
5. 靳懷明,李浩,李志華.顱腦損傷術后遲發性腦缺血性損害及其相關性因素[J].河南外科學雜志,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展[J].中華創傷雜志,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].西安交通大學學報醫學版,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.

《華西醫學》

腦損傷患者凝血功能水平和預后的相關性探討

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《華西醫學》

腦損傷患者凝血功能水平和預后的相關性探討

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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