严重创伤患者纤溶异常的研究进展  

The advances of fibrinolytic abnormalities in severe trauma patients

作　　者：徐文心 封启明[1] Xu Wen-xin;Feng Qi-ming(Department of Emergency Medicine, Shanghai Jiao Tong University Affiliated Sixth People′s Hospital, Shanghai 200233, China)

机构地区：[1]上海交通大学附属第六人民医院急诊医学科,上海200233

出　　处：《中国急救医学》2019年第2期196-200,共5页Chinese Journal of Critical Care Medicine

摘　　要：创伤发生后人体的凝血系统会大量激活,但至少有四分之一的创伤患者会出现创伤性凝血病,且此类患者常伴有纤溶异常,引起病死率升高,预后变差。纤溶异常包括纤溶关闭和纤溶亢进,前者纤溶能力降低,患者血栓形成风险提高;后者纤溶过剩,患者常伴有大出血。除了常规凝血检查外,纤溶异常的诊断主要依靠粘弹性凝血功能检测。本文将对纤溶异常的最新实验结果和研究进展进行总结,希望能为严重创伤患者纤溶异常的诊断和治疗提供新的思路。Despite a profound up -regul.ation in procoagulant mech/misms,at least one -quarter of trauma patients present with trauma -induced coagulopathy.These patients usually have post injury fibrinolytic abnormalities,which is associated with an increase in mort.ality and worse outcomes. Fibrinolytic abnormalities include fibrinolysis shutdown and hyperfibrinolysis.The former represents a deficiency of clot degradation and increased risk of thrombosis;the later appears primarily as an excess in clot degradation.Except conventional coagulation test,the diagnosis of fibrinolytic abnormalities mainly depends on viscoelastic hemostatic assay.This review covers the most recent evidence and advances in fibrinolytic abnormalities,which provides a new idea on the diagnosis and treatment for severe trauma patients with it.

关 键 词：纤溶关闭 纤溶亢进 创伤性凝血病(TIC) 血栓弹力图(TEG) 

分 类 号：R641[医药卫生—外科学]