Changes Of Coagulation Function And DIC Score In Patients With Moderate And Severe Craniocerebral Injury Clinical Research

Objective:Craniocerebral injury is a common disease in Department of Neurosurgery,which has high morbidity and disability.The changes of blood coagulation function after craniocerebral injury,especially in severe craniocerebral injury.In recent years,more and more attention has been paid to the changes of coagulation function after traumatic brain injury.In this study,the changes of blood coagulation indexes in the patients with moderate and severe craniocerebral injury were monitored,and the correlation between the severity of brain injury and blood coagulation index was obtained.The coagulation index and DIC score were used to evaluate the prognosis.Method:Collect 74 cases of Shanxi Medical University affiliated Dayi Hospital Department of neurosurgery in January-in June 2016 of severe traumatic brain injury(24h admission,GCS score less than or equal to 12)hospitalized patients,according to the GCS score,divided into moderate craniocerebral injury(29 cases),severe craniocerebral injury(45cases).And collected 20 in Shanxi health examination as the control group in ShanxiDayi Hospital.Patients with brain injury in 24 hours of blood coagulation and platelet testing.All the collected cases should exclude the following cases: severe craniocerebral trauma complicated with other organ injury;a history of liver disease,blood disease and diabetes may influence the blood coagulation function in patients before blood specimens were collected;infusion of whole blood or blood products to patients;blood samples collected before,to give emergency surgery before blood samples;collection,drug use affect coagulation function.The DIC score was calculated according to the blood coagulationindex and platelet,in order to understand the relationship between blood coagulation index,DIC score and the severity of brain injury.At the same time,all patients were followed up for 6 months after the trauma,and according to the follow-up results according to Glasgow Outcome Scale(Glasgowoutcomescale)were randomly divided into three groups: good prognosis group(4-5),prognosis group(1-3).The samples collected were statistically analyzed using SPSS17.0 statistical software to process data,the mean and standard deviation for all measurement data(mean + standard deviation)said,for rank test,p<0.05 had statistical significance,parallel ROC curve.Result:The changes of blood coagulation function after brain injury,in this study,the incidence of abnormal coagulation function was 86.5% in severe craniocerebral injury,and the incidence of coagulation abnormality in the patients with moderate or severe craniocerebral injury was about 79.3% and 91.1%,respectively.According to the score of GCS,the coagulation indexes PT,TT,Fib,D-dimer were significantly changed,with statistical significance;but the changes of APTT,and platelet parameters were not statistically significant.According AT-Ⅲto the GOS score group,the PT,D-dimer,DIC score had significant changes,and had statistical signifi-cance,but TT,APTT,AT-Ⅲ,Fib,platelet change was not statistically significant.According to the ROC curve,the area of PT,D-dimer and DIC score were calculated as 0.693,0.646,and 0.779,respectively.Conclusion:1.There is a wide range of abnormal coagulation function after severe craniocerebral injury.2.In severe craniocerebral injury,the more severe injury,the higher the incidence of coagulation dysfunction,the greater the change of coagulation index.3.PT,D-two,DIC score can make a certain judgment on the prognosis.According to the ROC curve,DIC score is more accurate and reliable than PT and D-dimer.