Li Baiqiang, Sun Haichen
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Chin J Traumatol. 2015;18(2):95-7. doi: 10.1016/j.cjtee.2015.01.003.
Acute coagulopathy of trauma-shock (ACoTS) occurs in 25% of patients with severe trauma in the early phase, and the mortality of those patients is four-fold higher than patients without coagulopathy. The pathophysiology of this complicated phenomenon has been focused on in recent years. Tissue injury and hypoperfusion, activated protein C and Complements play important roles in the early phase after trauma. While the use of blood products, hypothermia, acidosis and inflammation are the main mechanism in late phase. Supplementing coagulation factors and platelets to improve ACoTS are inefficient. Only positive resuscitation from shock and improving tissue hypoperfusion have expected benefits.
创伤性休克急性凝血病（ACoTS）在25%的严重创伤患者早期出现，这些患者的死亡率比没有凝血病的患者高四倍。近年来，这一复杂现象的病理生理学受到了关注。组织损伤和低灌注、活化蛋白C和补体在创伤后的早期阶段起重要作用。而使用血液制品、体温过低、酸中毒和炎症是后期的主要机制。补充凝血因子和血小板以改善ACoTS效果不佳。只有从休克中进行积极复苏并改善组织低灌注才有望带来益处。
