Knudsen F
Aalborg Sygehus, anaestesiologisk/intensiv afdeling.
Ugeskr Laeger. 1991 Jul 29;153(31):2173-6.
Exposure of subendothelial collagen and release of tissue thromboplastin render possible activation of both the internal and external coagulation cascades in traumatic lesions of the brain. Disseminated intravascular coagulation (DIC) is well described in brain lesions and may contribute to the haemorrhagic tendency in brain-injured patients. DIC is also suggested as a contributory factor for the degree of secondary brain damage and the development of pulmonary complications and tardive intracranial haematomata. The literature concerning DIC and traumatic brain damage is, however, difficult to assess as many of the materials include multitraumatized patients and the diagnostic criteria for DIC vary. In addition, it is difficult to differentiate between normal physiological phenomena and genuine pathological processes. No controlled and randomized investigations concerning the effects of specific antithrombotic treatment of DIC in traumatic lesions of the brain are available. It is recommended that patients with brain injuries should be examined for the development of disturbances of coagulation and that the relevant laboratory investigations should be included in assessment of this patient group.
脑外伤时，内皮下胶原暴露和组织凝血活酶释放可激活内源性和外源性凝血途径。弥漫性血管内凝血（DIC）在脑损伤中已有充分描述，可能是脑损伤患者出血倾向的原因之一。DIC也被认为是继发性脑损伤程度、肺部并发症及迟发性颅内血肿发生的一个促成因素。然而，由于许多资料纳入了多发伤患者且DIC的诊断标准各异，有关DIC与创伤性脑损伤的文献难以评估。此外，正常生理现象与真正的病理过程也很难区分。目前尚无关于DIC特异性抗栓治疗对脑外伤影响的对照随机研究。建议对脑损伤患者检查凝血功能紊乱情况，相关实验室检查应纳入该患者群体的评估之中。
