Patient demographic and injury characteristics.

BackgroundCoagulation disorders are serious complications of traumatic brain injury (TBI), yet the predictive value of thromboelastography (TEG) for deep vein thrombosis (DVT) in this population remains unclear. This study aimed to assess the TEG profiles and four conventional coagulation parameters in patients with isolated TBI at multiple time points to predict the risk of early DVT.MethodsIn this retrospective study, 71 patients with isolated TBI were enrolled and categorized into thrombosis (n = 30) and non-thrombosis (n = 41) groups based on Doppler ultrasound and pulmonary angiography findings. Conventional coagulation parameters (PT, APTT, FIB, D-Dimer, TT, PLT) and TEG parameters (R, α-angle, MA) were systematically measured at 24, 72, and 168 hours post-injury. Statistical analyses included group comparisons and binary logistic regression to identify independent predictors of thrombosis.ResultsPatients who developed thrombosis had significantly lower Glasgow Coma Scale (GCS) scores (p ConclusionsIn isolated TBI, coagulation abnormalities evolved dynamically during the first week after injury. Conventional coagulation parameters, particularly prothrombin time and D-dimer, were more informative for venous thrombosis risk assessment, whereas TEG reflected global hypercoagulability without providing independent predictive value.

背景：凝血功能障碍是创伤性脑损伤（traumatic brain injury, TBI）的严重并发症，但血栓弹力图（thromboelastography, TEG）对该人群深静脉血栓（deep vein thrombosis, DVT）的预测价值仍不明确。本研究旨在通过多时间点检测孤立性TBI患者的TEG参数与四项常规凝血指标，以预测早期DVT的发生风险。
方法：本研究为回顾性研究，纳入71例孤立性TBI患者，根据多普勒超声与肺动脉造影结果分为血栓组（n=30）与非血栓组（n=41）。分别于伤后24、72及168小时系统检测常规凝血参数[凝血酶原时间（prothrombin time, PT）、活化部分凝血活酶时间（activated partial thromboplastin time, APTT）、纤维蛋白原（fibrinogen, FIB）、D-二聚体（D-Dimer）、凝血酶时间（thrombin time, TT）、血小板计数（platelet, PLT）]及TEG参数（R值、α角、MA值）。统计学分析采用组间比较与二元logistic回归，以明确血栓形成的独立预测因素。
结果：发生血栓的患者格拉斯哥昏迷量表（Glasgow Coma Scale, GCS）评分显著更低（p<0.05），且伤后早期多个时间点的常规凝血参数与TEG参数均存在异常。二元logistic回归分析显示，常规凝血指标而非TEG参数为早期DVT的独立预测因素。
结论：孤立性TBI患者的凝血功能异常在伤后第一周呈动态演变。常规凝血参数（尤其是凝血酶原时间与D-二聚体）对静脉血栓形成风险的评估价值更高，而TEG仅能反映整体高凝状态，无法提供独立的预测价值。