U.S. Army Institute of Surgical Research, 3698 Chambers Pass, JBSA-Fort Sam Houston, Houston, TX 78234-6315 USA.
Mil Med Res. 2016 Nov 22;3:35. doi: 10.1186/s40779-016-0105-2. eCollection 2016.
Traumatic injury is one of the leading causes of death, with uncontrolled hemorrhage from coagulation dysfunction as one of the main potentially preventable causes of the mortality. Hypothermia, acidosis, and resuscitative hemodilution have been considered as the significant contributors to coagulation manifestations following trauma, known as the lethal triad. Over the past decade, clinical observations showed that coagulopathy may be present as early as hospital admission in some severely injured trauma patients. The hemostatic dysfunction is associated with higher blood transfusion requirements, longer hospital stay, and higher mortality. The recognition of this early coagulopathy has initiated tremendous interest and effort in the trauma community to expand our understanding of the underlying pathophysiology and improve clinical treatments. This review discusses the current knowledge of coagulation complications following trauma.
创伤是导致死亡的主要原因之一,其中由凝血功能障碍导致的失控性出血是主要的潜在可预防致死原因之一。低体温、酸中毒和复苏性血液稀释被认为是创伤后凝血表现的重要因素,被称为致死三联征。在过去的十年中,临床观察显示,在一些严重创伤患者中,入院时可能就已经存在凝血功能障碍。止血功能障碍与更高的输血需求、更长的住院时间和更高的死亡率有关。对这种早期凝血功能障碍的认识激发了创伤领域极大的兴趣和努力,以加深我们对潜在病理生理学的理解并改善临床治疗。本文综述了创伤后凝血并发症的现有知识。