Bick R L
Department of Medicine, University of California, Los Angeles.
Hematol Oncol Clin North Am. 1992 Dec;6(6):1259-85.
Current concepts of the etiology, pathophysiology, clinical and laboratory diagnosis, and management of fulminant and low-grade DIC have been presented. Considerable attention has been devoted to interrelationships within the hemostasis system. Only by clearly understanding these pathophysiologic interrelationships can the clinician and laboratory scientist appreciate the divergent and wide spectrum of often confusing clinical and laboratory findings in patients with DIC. Many therapeutic decisions to be made are controversial and will remain so until more is published about specific therapeutic modalities and survival patterns. Also, therapy must be highly individualized depending on the nature of DIC, age, etiology of DIC, site and severity of hemorrhage or thrombosis, and hemodynamic and other clinical parameters. Many syndromes that are organ-specific share common pathophysiology with DIC but are typically identified as an independent disease entity, such as hemolytic uremic syndrome, adult shock-lung syndrome, eclampsia, and many other isolated "organ-specific" disorders.
本文介绍了暴发性和低度弥散性血管内凝血（DIC）的病因、病理生理学、临床和实验室诊断以及治疗的当前概念。人们对止血系统内部的相互关系给予了相当多的关注。只有清楚地了解这些病理生理相互关系，临床医生和实验室科学家才能理解DIC患者常常令人困惑的临床和实验室检查结果的多样性和广泛范围。许多要做出的治疗决策存在争议，在更多关于特定治疗方式和生存模式的研究发表之前，这种争议仍将存在。此外，治疗必须高度个体化，这取决于DIC的性质、年龄、DIC的病因、出血或血栓形成的部位和严重程度以及血流动力学和其他临床参数。许多器官特异性综合征与DIC具有共同的病理生理学，但通常被确定为独立的疾病实体，如溶血性尿毒症综合征、成人休克肺综合征、子痫以及许多其他孤立的“器官特异性”疾病。
