Schulte am Esch J, Pfeifer G, Etzel F
Prakt Anaesth. 1977 Dec;12(6):471-7.
Factors II, V, X, VIII, thrombin time, platelet count and the thrombelastogram were estimated in 58 persons who had suffered cerebrocranial injuries of varying degree of severity. The aim of the investigation was to elucidate whether and to what extent the injury affected these parameters and whether the destruction of brain tissue could be regarded as the sole cause of the impairment of the clotting mechanism. First estimations in cases of cerebrocranial trauma uncomplicated by other injuries and in cases of cerebrocranial trauma complicated by moderately severe other injuries showed changes in factors II, V, X, VII as well as a pathological thrombelastogram, viz.: hypercoagulability. More pronounced changes were observed in cases where the cerebrocranial injuries were associated with severe complicating lesions: factors II, V, VII, X and the platelet count were reduced by 50-70 per cent of their normal values. Subsequent estimations carried out over a period of 15 days showed that the clotting mechanism had returned to nearly normal within 6-10 days. The use of heparin for normalizing disturbances of the clotting mechanism in cerebrocranial injuries is discussed.
对58名患有不同严重程度颅脑损伤的患者进行了凝血因子II、V、X、VIII、凝血酶时间、血小板计数和血栓弹力图检测。本研究的目的是阐明损伤是否以及在何种程度上影响这些参数，以及脑组织的破坏是否可被视为凝血机制受损的唯一原因。对无其他损伤并发症的颅脑外伤病例和伴有中度严重其他损伤的颅脑外伤病例的首次检测显示，凝血因子II、V、X、VII以及血栓弹力图出现变化，即：高凝状态。在颅脑损伤伴有严重并发症的病例中观察到更明显的变化：凝血因子II、V、VII、X和血小板计数降至正常值的50% - 70%。在15天内进行的后续检测显示，凝血机制在6 - 10天内已恢复至接近正常水平。文中讨论了使用肝素使颅脑损伤患者的凝血机制紊乱恢复正常的问题。
