Kino Shuichi, Takenaka Susumnu, Niizeki Noriyasu, Hanada Daisuke, Tomoda Yutaka, Akasaka Kazumi, Ito Yoshihisa
Department of Medical Laboratory and Blood Center, Asahikawa Medical University Hospital, Asahikawa 078-8510, Japan.
Rinsho Byori. 2011 Jul;59(7):670-5.
The microvascular bleeding resulting from the dilutional coagulopathy can occur when patients with massive blood loss are treated by infusing a lot of crystalloids, colloids, and red blood cell concentrates. For the management of dilutional coagulopathy and the appropriate replacement therapy of with coagulation factors and platelets, we usually monitor the patient's course of with platelet count, conventional coagulation tests such as the prothrombin time, the activated partial prothrombin time, and the fibrinogen concentration. The central clinical laboratory has a responsibility for an accurate and quick report of these test results of patients with massive transfusion. Furthermore, use of point care testing is of clinical value to fulfill a clinical demand in case with dilutional coagulopathy.
当大量失血患者通过输注大量晶体液、胶体液和红细胞浓缩物进行治疗时，可能会发生稀释性凝血病导致的微血管出血。对于稀释性凝血病的管理以及凝血因子和血小板的适当替代治疗，我们通常通过血小板计数、常规凝血试验（如凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原浓度）来监测患者的病程。中心临床实验室有责任准确、快速地报告大量输血患者的这些检测结果。此外，即时检验的应用对于满足稀释性凝血病情况下的临床需求具有临床价值。
