初级爆震伤后凝血功能变化的研究进展  

Advances in research on changes of coagulation system after primary blast injury

作　　者：李开源 冯聪[1] 陈力[1] 潘菲[1] 张恒[1] 黎檀实[1] Li Kaiyuan;Feng Cong;Chen Li;Pan Fei;Zhang Heng;Li Tanshi(Department of Emergency,the First Medical Center to Chinese People's Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心急诊科,北京100853

出　　处：《中华危重病急救医学》2020年第5期632-635,共4页Chinese Critical Care Medicine

基　　金：国家自然科学基金(81701961);国家重点研发计划项目(2019YFF0302300);军队后勤科研重大专项(AWS15J004,BWS14J042);军事医学创新专项(14CXZ005)。

摘　　要：爆震伤是战场上的主要致伤原因,在民用领域和现代社会也时有发生。相比其他创伤,爆震伤对受害者造成的损伤更为复杂和严重。初级爆震伤是爆震伤中的常见类型,可造成多器官损伤且机制复杂,组织和血管内皮损伤及低灌注是大多数器官损伤的一致表现;但由于初级爆震伤较隐匿,早期不易及时发现,初级爆震伤后凝血功能及酸碱平衡变化研究可能为其早期的诊断和干预带来益处,从而改善爆震伤伤员的预后和病死率。目前国内外对初级爆震伤的研究多聚焦于单个器官损伤,缺乏对系统性凝血及酸碱平衡变化的探讨,还有待进一步研究,这些研究对于初级爆震伤早期诊断的提高和一线救治措施的优化都具有一定现实意义。本文针对初级爆震伤的致伤特点、流行病学、致伤机制及其与创伤性凝血病(TIC)的关系进行综述,以期为爆震伤相关研究提供参考。Blast injury is the main cause of injury in the battlefield,which also occurs frequently in the civil field and modern society.The damage caused by blast is more complicated than other types of trauma.Primary blast injury is a common type of blast injury,which can cause multiple organ damage with complex mechanism.Tissue and vascular endothelium damage and organ hypoperfusion are the consistent manifestations of most organ damage.However,due to the concealed damage caused by the primary blast injury,it is difficult to recognize it in time.The study of coagulation function and acid-base balance change after primary blast injury can bring benefits to its early diagnosis and intervention,thus improving the prognosis and mortality of blast injury.However,at present,the research on primary blast injury mostly focuses on single organ damage.Lack of research on systemic coagulation and acid-base balance changes calls for further research.Such research has a practical significance for the early diagnosis and optimization of tactical care for primary blast injury.This article reviews the injury characteristics,epidemiology,mechanism and the relationship with trauma-induced coagulopathy(TIC)in primary blast injury to provide reference for related researches.

关 键 词：初级爆震伤 创伤性凝血病 动物模型 

分 类 号：R826.5[医药卫生—临床医学]