Clinical Value Of Coagulation And Fibrinolysis Changes In Acute Period Post Traumatic Brain Injury

[Objective]To explore variation tendency and clinical significance of the sixplasma parameters(PT,APTT,TT,Fbg,FDP and D-D)in patients with acutetraumatic brain injury,and to evaluate the relationship between them andthe severity of brain injury(GCS)and patients’outcomes(GOS).At the sametime,to observe the effects of level PT,APTT,TT,Fbg and D-dimer in plasmaon delayed traumatic intracerebral hematoma(DTIH) or enlargement ofpreviously small hematomas.[Methods]We detected the levels of PT,APTT,TT,Fbg,FDP and D-D in fifty acutetraumatic brain injury patients by Chromogenic analysis method andlatex-enhanced immunoturbidimetric test at seven different time points(4,8,16,24,36,48,72hours after injury).Their levels were compared withcontrol group.Then we classified the patients by the severity of trauma(GCS≤8group and GCS＞8group)and outcomes (good and bad prognosis), andif developed delayed traumatic intracerebral hematoma (DTIH group andnon-DTIH group),compared the PT,APTT,TT,Fbg,FDP and DD levels between thedifferent groups.Finally we analyze the data with SPSS(version17.0).[Results]1.There was significant difference in the levels of FDP,D-D between braininjury group and normal control group at all different time points,andthe discrepancies were statistically significant(P＜0.05).The levels ofAPTT,Fbg,PT,TT between brain injury group and normal controls group werenot all statistically significant(P＞0.05).1. Compared with group GCS＞8,the levels of FDP,D-D were significantlyhigher than group GCS≤8at all different time points,and the discrepancies were statistically significant (P＜0.05).The levels ofAPTT,Fbg,PT,TT between group GCS＞8and group GCS≤8were not allstatistically significant(P＞0.05).2. Compared with DTIH group,the levels of FDP,D-D were significantlyhigher than Non-DTIH group at all different time points,and thediscrepancies were statistically significant (P＜0.05).Compared with badprognosis group,the levels of FDP,D-D were significantly higher thanthose with good prognosis(P＜0.05) at all different time points,and thediscrepancies were statistically significant (P＜0.05).The levels ofAPTT,Fbg,PT,TT between DTIH group and Non-DTIH group were not allstatistically significant(P＞0.05),and ditto between bad prognosis groupand good prognosis group.[Conclusions]1. Patients with acute traumatic brain injury existing blood coagulationabnormal,show that high agglutination condition was appearing in thetraumatic brain injury aged4h.Coagulation indexes has switched from highagglutination condition to secondary hyperfibrinolysis stage at8hpost-trauma and continued to72h.2.Coagulation dysfunction after traumatic brain injury closely relatedto injury level.The more severe the traumatic brain injury was, the moreobvious the coagulation disorders was,coagulation disorders are valuablein evaluating the prognosis of traumatic brain injury.3.The FDP and D-D(D-dimer) levels in patients were more sensitive thanPT,APTT,TT,Fbg to reflecting clotting and fibrinolysis stage in patientswith traumatic brain injury.