创伤引起的凝血病:你需要知道的
Lydia Buzzard1, Martin Schreiber
1From the University of Wisconsin School of Medicine and Public Health (L.B.), Madison, Wisconsin; and Department of Surgery (L.B., M.S.), Oregon Health and Science University, Portland, Oregon.
The journal of trauma and acute care surgery
|October 13, 2023
概括
创伤引起的凝血病 (TIC) 是一种严重的疾病,影响25%的创伤患者. 早期干预出血控制和血液制品对于管理这种复杂的炎症状态至关重要.
科学领域:
- 创伤学 创伤学 创伤学
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 创伤诱发性凝血病 (TIC) 是对严重损伤的全身炎症反应,影响大约25%的患者.
- 它的特点是凝血失调,酸血和低温,发病率与损伤严重程度相关.
- 多因素机制有助于TIC,包括内皮激活,凝血因子消耗和血小板功能障碍.
研究的目的:
- 为创伤诱导的凝血病提供全面的概述.
- 讨论ICT的诊断方法和当前的治疗策略.
- 突出在医院前和医院环境中早期干预的重要性.
主要方法:
- 诊断包括常规的凝血测试 (例如PT,aPTT),粘弹性静血测试 (例如TEG,ROTEM) 和临床评分系统.
- 医院前的管理重点是早期的出血控制,血液产品的复苏,和tranexamic酸的管理.
- 医院内治疗的重点是控制出血,输血血液成分,并纠正代谢障碍,如酸和低温症.
主要成果:
- 这种TIC表现为全身炎症,凝血异常,酸性和低温.
- 诊断工具范围从标准实验室测试到先进的粘弹性测试.
- 有效的管理需要采取多方面的方法,解决ICT的根本原因和后果.
结论:
- 早期识别和管理TIC对于改善患者结果至关重要.
- 医院前和医院内干预措施的结合是必要的,以获得最佳的护理.
- 继续研究前医院治疗方法,如前血栓复合物缩剂是有必要的.
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