The Correlation Between Early Coagulation Fibrinolysis And Delayed Traumatic Intracranial Hematoma In Patients With Traumatic Brain Injury

BackgroundTraumatic brain injury（TBI）is a kind of clinical disease with high lethality and disability rate.The increasing morbidity of traumatic brain injury is becoming a serious threat to the health of middle-aged and young people in our country.Delayed traumatic intracranial hematoma（DTIH）is an important factor affecting the prognosis of patients with traumatic brain injury.One of the common complications of patients with traumatic brain injury is coagulation dysfunction,which has a significant impact on the progress of patients’clinical conditions.It occurs in about 2/3 of patients with traumatic brain injury^[1-2].However,few studies have found a correlation between early coagulation function changes and delayed traumatic intracerebral hematoma in patients with brain injury.This article retrospectively analyzed the indicators of blood coagulant function in 152 patients with traumatic brain injury,discussed its relationship with the severity of traumatic brain injury and delayed traumatic intracerebral hematoma.ObjectivesTo explore the correlation between early blood coagulation fibrinolysis and delayed traumatic intracranial hematoma（DTIH）in patients with traumatic brain injury（TBI）in order to provide a clinical basis for predicting the occurrence of delayed intracerebral hematoma,thereby reducing the morbidity of delayed traumatic intracranial hematoma and improving the prognosis of traumatic brain injury patients.Methods152 patients with traumatic brain injury treated at our hospital during the period from2016.7 to 2017.7 were divided into mild（69 cases）,medium（45 cases）,severe（38 cases）groups according to the Glasgow Coma Scale（GCS）.All patients’blood samples were taken immediately after admission and tested for the following seven coagulant function indicators:prothrombin time（PT）,partial activated thromboplastin time（APTT）,fibrinogen（Fbg）,thrombin time（TT）,fibrin degradation product（FDP）,D-dimer（DD）,and platelet（PLT）.According to whether or not delayed intracerebral hematoma occurred after treatment,all patients were divided into delayed intracranial hematoma group（45cases）and non-delayed intracranial hematoma group（107 cases）.All the indicators of coagulant function were compared among groups.Results1.The indicators of coagulation function in patients with traumatic brain injury may be abnormal.With the severity of craniocerebral injury,the probability of abnormalities of PT,Fbg,FDP,PLT increases gradually（P<0.05）.The probability of abnormalities in PT,APTT,Fbg,TT,FDP and PLT in the mild group was significantly lower than that in the medium group and severe group（P<0.05）;the probability of abnormalities in the DD in the mild group was significantly lower than that in the severe group（P<0.05）;The probability of abnormalities in PT,Fbg,DD,FDP and PLT was significantly lower in the group than in the heavy group（P<0.05）.2.The probability of abnormalities in PT,APTT,Fbg,D-D,and FDP was significantly higher in the delayed intracranial hematoma group than in the non-delayed intracranial hematoma group（P<0.05）.The morbidity of delayed intracerebral hematoma was significantly lower in the group with mild traumatic brain injury than that in the medium middle and severe group（P<0.05）.There was no significant difference in the morbidity of delayed intracerebral hematoma between the medium and severe group of patients with traumatic brain injury（P>0.05）.Conclusions1.The early indicators of coagulation function in patients with traumatic brain injury may be abnormal.The probability of abnormality is closely related to the severity of craniocerebral injury.It can be used as a reference index to assess the condition and prognosis of patients.2.Abnormalities of early PT,APTT,Fbg,D-D and FDP in patients with craniocerebral injury,especially those with medium and severe traumatic brain injury,can be used as indicators for predicting the occurrence of delayed intracerebral hematoma.