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| Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury | |
| 作者姓名： | 裘五四 王卫民 杜红英 刘伟国 沈宏 沈磊芬 祝鸣兰 |
| 作者单位： | Department of Neurosurgery 2nd Affiliated Hospital of School of Medicine Zhejiang University，Department of Neurosurgery Hangzhou Second Hospital Affiliated to Hangzhou Normal College，Department of Neurosurgery Hangzhou Second Hospital Affiliated to Hangzhou Normal College，Department of Neurosurgery 2nd Affiliated Hospital of School of Medicine，Zhejiang University，Department of Neurosurgery 2nd Affiliated Hospital of School of Medicine，Zhejiang University，Department of Neurosurgery Hangzhou Second Hospital Affiliated to Hangzhou Normal College，Department of Neurosurgery 2nd Affiliated Hospital of School of Medicine，Zhejiang University，Hangzhou 310009，China，Hangzhou 310012，China，Hangzhou 310012，China，Hangzhou 310009，China，Hangzhou 310009，China，Hangzhou 310012，China，Hangzhou 310009，China |
| 摘 要： | Objective: To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury (TBI). Methods:Ninety-six inpatients with severe brain injury were randomized into three groups: SBC (selective brain cooling) group (n=24), MSH (mild systemic hypothermia ) group (n=30), and control (normothermia) group (n=42). The platelet counts and prognosis were retrospectively analyzed. Results: Thrombocytopenia was present in 18 (75%), 23 (77%) and 15 (36%) patients in SBC group, MSH group and control group, respectively (P<0. 01). Thrombocytopenia, in which the minimum platelet count was seen 3 days after hypothermia, showed no significant difference between SBC and MSH group (P>0.05). Most platelet counts (37 cases, 90 %) in hypothermia group were returned to normal level after 1 to 2 days of natural rewarming. The platelet count in SBC group reduced by 16%, 27% and 29% at day 1, 3 and 5 respectively compared with the baseline value. Good recovery ( GOS score 4-5) rate of thrombocytopenia 1 year after injury for hypothermia group (17 cases, 37%) was significantly lower than that of control group (P < 0.01). Conclusions: Therapeutic hypothermia increases the incidence of thrombocytopenia in severe TBI, and patients with thrombocytopenia after therapeutic hypothermia are associated with unfavorable neurological prognosis. |
| 关 键 词： | 血小板减少症 低温治疗 脑损伤 病理机制 |
| 收稿时间： | 2005-10-26 |
Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury |
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| QIU Wu-si,WANG Wei-min,DU Hong-ying,LIU Wei-guo,SHEN Hong,SHEN Lei-fen,ZHU Ming-lan.Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury[J].Chinese Journal of Traumatology(English Edition),2006,9(4):238-241. | |
| Authors: | QIU Wu-si WANG Wei-min DU Hong-ying LIU Wei-guo SHEN Hong SHEN Lei-fen ZHU Ming-lan |
| Affiliation: | 1. Department of Neurosurgery, 2nd Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou 310009,China;Department of Neurosurgery, Hangzhou Second Hospital Affiliated to Hangzhou Normal College, Hangzhou 310012,China 2. Department of Neurosurgery, Hangzhou Second Hospital Affiliated to Hangzhou Normal College, Hangzhou 310012,China 3. Department of Neurosurgery, 2nd Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou 310009,China |
| Abstract: | To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury (TBI). Methods:Ninety-six inpatients with severe brain injury were randomized into three groups: SBC (selective brain cooling) group (n=24), MSH (mild systemic hypothermia ) group (n=30), and control (normothermia) group (n=42). The platelet counts and prognosis were retrospectively analyzed. Results: Thrombocytopenia was present in 18 (75%), 23 (77%) and 15 (36%) patients in SBC group, MSH group and control group, respectively (P<0. 01). Thrombocytopenia, in which the minimum platelet count was seen 3 days after hypothermia, showed no significant difference between SBC and MSH group (P>0.05). Most platelet counts (37 cases, 90 %) in hypothermia group were returned to normal level after 1 to 2 days of natural rewarming. The platelet count in SBC group reduced by 16%, 27% and 29% at day 1, 3 and 5 respectively compared with the baseline value. Good recovery ( GOS score 4-5) rate of thrombocytopenia 1 year after injury for hypothermia group (17 cases, 37%) was significantly lower than that of control group (P < 0.01). Conclusions: Therapeutic hypothermia increases the incidence of thrombocytopenia in severe TBI, and patients with thrombocytopenia after therapeutic hypothermia are associated with unfavorable neurological prognosis. |
| Keywords: | Traumatic brain injury Hypothermia Thrombocytopenia Prognosis |
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