摘要
Abstract
Objective To investigate the evaluation value of the drug[platelet arachidonic acid(AA),platelet adenosine diphosphate(ADP)]inhibiting rate combined with blood clot formation time(K value),age and GCS score on the prognosis of the patients with blunt severe traumatic brain injury(TBI).Methods A total of 184 patients with acute blunt severe TBI without using antiplatelet drugs admitted and treated in this hospital from January 2021 to December 2022 were selected.The patients were divided into good prognosis group and poor prognosis group according to their condition improvement on 28 d.The general data of the two groups were compared.The venous blood was collected in both groups.The TEG examination was conducted in the two groups and the coagulation reaction time(R),K value,maximum amplitude of clot formation(MA value),formation rate(α angle),blood clot mechanical strength(G value),AA inhibition rate and ADP inhibi-tion rate were compared between the two groups,and the multivariate Logistic regression analysis was used to analyze the risk factors affecting the poor prognosis of the patients with blunt severe TBI.The receiver operat-ing characteristic(ROC)curve was used to analyze the evaluation value of drug inhibiting rate combined with K value,age and GCS score in the prognosis in the patients with blunt severe TBI.Results There were 138 cases in the good prognosis group and 46 cases in the poor prognosis group.The patients with age≥45 years old,head AIS score(5-6 points),intubation ratio after admission,K value,AA inhibition rate and ADP inhi-bition rate in the poor prognosis group were significantly higher than those in the good prognosis group,and R value,α angle,MA value,G value and GCS score were significantly lower than those in the good prognosis group,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that age ≥45 years old,the increase of K value,AA inhibiting rate and ADP inhibiting rate were the risk fac-tors affecting poor prognosis in the patients with blunt severe TBI.The increase of GCS score was a protective factor for the good prognosis of patients with blunt sever TBI(P＜0.05).The ROC curve analysis found that the AA inhibiting rate,ADP inhibiting rate,age,K value and GCS score combined detection had the high eval-uation value for the prognosis in blunt severe TBI.Conclusion The increase of AA inhibiting rate and ADP inhibiting rate,GCS score decrease and K value increase could serve as the early warning indicators to assist in assessing the prognosis of the patients with blunt severe TBI.关键词
药物抑制率/血凝块形成时间/格拉斯哥昏迷评分/重症钝性颅脑损伤/严重程度/预后Key words
drug inhibiting rate/K value/GCS score/blunt traumatic brain injury/severe/prognosis分类
医药卫生
