论文部分内容阅读
目的:探讨头胸部多发伤对机体凝血功能的影响。方法:头胸部多发伤48例(头胸外伤组),同期收治胸外伤81例(胸外伤组)、头外伤138例(头外伤组),比较3组治疗经过、疗效、出血情况及手术比例,观察凝血异常率与病程的关系以及迟发颅内出血的主要时间段。结果:与头外伤组比较,头胸外伤组颅内血肿量多、迟发颅内出血的比例及病死率高(P<0.05);与胸外伤组比较,头胸外伤组胸腔闭式引流比例及病死率高,引流量大,引流时间长(P<0.05);与胸外伤组、头外伤组比较,头胸外伤组凝血酶时间、凝血酶原时间、活化部分凝血活酶时间及凝血酶原国际标准化比率延长,血浆纤维蛋白原及血小板计数降低,差异均有统计学意义(P<0.05)。入院前3 d凝血异常率逐渐升高,之后下降。头胸外伤组、头外伤组迟发颅内出血主要发生于入院后第2天和第3天。结论:头、胸部多发伤相互影响,加重了凝血功能异常与出血倾向,入院后第2天和第3天为迟发颅内出血的高峰期。
Objective: To investigate the effect of head-chest multiple injuries on the coagulation function of the body. Methods: Forty-eight cases of head and thoracic trauma (head-chest trauma group), 81 cases of thoracic trauma (thoracic trauma group) and 138 head trauma cases (head trauma group) were treated in the same period. The treatment effect, bleeding, , Observe the relationship between the rate of abnormal coagulation and the course of disease and the main time period of delayed intracranial hemorrhage. Results: Compared with the head trauma group, the proportion of intracranial hematoma and delayed intracranial hemorrhage in the head and neck trauma group was significantly higher (P <0.05). Compared with the thoracic trauma group, the proportion of closed thoracic drainage in head and thoracic trauma group and (P <0.05). Compared with thoracic trauma group and head trauma group, thrombin time, prothrombin time, activated partial thromboplastin time and prothrombin time The international standardization rate was prolonged, plasma fibrinogen and platelet count decreased, the differences were statistically significant (P <0.05). Coagulation abnormalities increased gradually 3 days before admission, then decreased. Head-chest trauma group, head trauma group delayed intracranial hemorrhage occurred in the first 2 days and 3 days after admission. Conclusion: The multiple head injuries and thoracic injuries affect each other, aggravating the tendency of coagulation dysfunction and bleeding. The second and third days after admission are the peak of delayed intracranial hemorrhage.