Hanke A A, Rahe-Meyer N
Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland,
Unfallchirurg. 2014 Feb;117(2):95-8. doi: 10.1007/s00113-013-2488-9.
The main cause of death in the patient group less than 45 years is trauma. Beside severe traumatic brain injury, bleeding remains a leading cause of death in this group. For a causal therapy, it is necessary to understand the pathophysiology of trauma-induced coagulopathy (TIC). Beside the well-known lethal triad of trauma (hypothermia, acidosis, and coagulopathy), dilution and hypoperfusion with activation of the protein C pathway play a crucial role. TIC is a complex independent syndrome which may be present without initial hypercoagulopathy. A rapid and differentiated diagnosis and goal-directed therapy is crucial for causal therapy.
45岁以下患者组的主要死因是创伤。除了严重的创伤性脑损伤外,出血仍是该组的主要死因。对于病因治疗,有必要了解创伤性凝血病(TIC)的病理生理学。除了众所周知的创伤致死三联征(低体温、酸中毒和凝血病)外,稀释和低灌注以及蛋白C途径的激活也起着关键作用。TIC是一种复杂的独立综合征,可能在没有初始高凝状态的情况下出现。快速且有针对性的诊断和目标导向治疗对于病因治疗至关重要。