中至重型颅脑创伤患者多次输血影响因素分析

doi:10.3969/j.issn.1672-6731.2020.07.009

中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (7): 608-613. doi: 10.3969/j.issn.1672-6731.2020.07.009

2 中至重型颅脑创伤患者多次输血影响因素分析

鲁华山¹, 赵德昌², 任彬¹, 赵顺忠¹, 朱宗远¹, 张大伟³, 房连申⁴, 李立宏¹

1 710038 西安, 空军军医大学唐都医院急诊科;
2 475000 开封, 河南大学第一附属医院神经外科;
3 510515 火箭军广州特勤疗养中心;
4 132500 蛟河, 解放军三一六九〇部队卫生连

收稿日期:2020-07-16 出版日期:2020-07-25 发布日期:2020-07-24
通讯作者: 李立宏,Email:lihongli777@163.com
基金资助:
陕西省重点研发计划项目（项目编号：2017ZDXM-SF-042）

Analysis on the risk factors for multiple transfusion in patients with moderate or severe traumatic brain injury

LU Hua-shan¹, ZHAO De-chang², REN Bin¹, ZHAO Shun-zhong¹, ZHU Zong-yuan¹, ZHANG Da-wei³, FANG Lian-shen⁴, LI Li-hong¹

1 Department of Emergency, Tangdu Hospital, Air Force Military Medical University of Chinese PLA, Xi'an 710038, Shaanxi, China;
2 Department of Neurosurgery, the First Affiliated Hospital of He'nan University, Kaifeng 475000, He'nan, China;
3 Rocket Force Guangzhou Special Service Recuperation Center, Guangzhou 510515, Guangdong, China;
4 Health Company, Chinese PLA 31690, Jiaohe 132500, Jilin, China

Received:2020-07-16 Online:2020-07-25 Published:2020-07-24
Supported by:
This study was supported by the Key Research and Development Program of Shaanxi Province (No. 2017ZDXM-SF-042).

摘要/Abstract

摘要：

目的分析中至重型颅脑创伤患者多次输血影响因素。方法 2018年1月至2019年6月行去骨瓣减压术的53例中至重型颅脑创伤患者，根据凝血功能、血小板计数和临床表现（如有无创面渗血）确定是否输血；采用单因素和多因素Logistic回归分析筛查造成反复多次输血的危险因素。结果根据输血次数分为多次输血组（11例）和对照组（未输血或仅术中单次输血，42例）。多次输血组患者凝血酶时间（P=0.041）、国际标准化比值（P=0.048）、纤维蛋白降解产物（P=0.000）和D-二聚体（P=0.001）水平均高于对照组，纤维蛋白原低于对照组（P=0.006）；Logistic回归分析显示，纤维蛋白降解产物是颅脑创伤患者反复多次输血的危险因素（OR=1.013，95% CI：1.005~1.021；P=0.002）。结论血清纤维蛋白降解产物水平升高是造成中至重型颅脑创伤患者反复多次输血的主要危险因素。

关键词: 脑损伤, 创伤性, 输血, 血液凝固障碍, 危险因素, Logistic模型

Abstract:

Objective To analyze the risk factors for multiple transfusions in patients with moderate or severe traumatic brain injury (TBI). Methods The clinical data of 53 patients undergoing decompressive craniectomy with moderate or severe TBI from January 2018 to June 2019 were analyzed. Coagulation indexes were tested before decompressive craniectomy. The factors associated with multiple transfusions were analyzed by univariate and multivariate Logistic regression analysis. Results Patients were divided into multiple transfusion group (11 cases) and control group (42 cases, no transfusion or single transfusion). Thrombin time (P=0.041), international normalized ratio (P=0.048), fibrinogen degradation product (P=0.000) and D-dimer (P=0.001) in the multiple transfusion group were higher than those in the control group, while fibrinogen was lower than those in the control group (P=0.006). Logistic regression analysis showed that fibrinogen degradation product was a risk factor for multiple transfusions (OR=1.013, 95%CI:1.005-1.021; P=0.002). Conclusions Elevated fibrinogen degradation product is a risk factor for multiple transfusions in patients with moderate or severe TBI.

Key words: Brain injuries, traumatic, Blood transfusion, Blood coagulation disorders, Risk factors, Logistic models

鲁华山, 赵德昌, 任彬, 赵顺忠, 朱宗远, 张大伟, 房连申, 李立宏. 中至重型颅脑创伤患者多次输血影响因素分析[J]. 中国现代神经疾病杂志, 2020, 20(7): 608-613.

LU Hua-shan, ZHAO De-chang, REN Bin, ZHAO Shun-zhong, ZHU Zong-yuan, ZHANG Da-wei, FANG Lian-shen, LI Li-hong. Analysis on the risk factors for multiple transfusion in patients with moderate or severe traumatic brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(7): 608-613.

http://journal11.magtechjournal.com/cjcnn/CN/Y2020/V20/I7/608

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