摘要
长期以来,严重创伤后凝血功能障碍被认为是凝血因子消耗与稀释所致,但近年来的研究表明创伤后凝血功能障碍在创伤后早期即出现。这种创伤后早期由于内源性凝血失衡导致的凝血功能障碍称之为急性创伤性凝血功能障碍(ATC),并发ATC伤者并发症、伤死率明显增加。传统凝血试验诊断凝血功能障碍能够提供的信息有限,以血栓弹力图分析仪、旋转式血栓弹力测定法为主要内容的黏弹性止血试验(VHA)更能反映复杂凝血过程的全貌,根据VHA结果实施的早期目标导向凝血治疗能够改变血液制品输注、改善创伤患者预后。
Coagulation dysfunction after major war trauma is conventionally attributed to consumption and dilution of coagulation factors.However,recent studies have identified an acute coagulation dysfunction at the early stage after trauma.This coagulation dysfunction due to endogenous coagulation disturbance at the early stage after trauma is called acute traumatic coagulation dysfunction（ATCD）,and the patients with ATCD would have an increased complication rate and mortality.Standard coagulation tests provide only limited information on the underlying coagulation disorder.Viscoelastic haemostatic assays（VHA） such as rotational thromboelastometry or thrombelastography offer a more comprehensive insight into the coagulation process.Early goal-directed coagulation therapy guided by VHA could change administration of blood products and improve diagnosis of trauma patients.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2013年第1期1-5,共5页
Medical Journal of Chinese People's Liberation Army
关键词
创伤和损伤
血液凝固障碍
诊断
治疗
wounds and injuries
blood coagulation disorders
diagnosis
therapy
