20xx年醫(yī)學(xué)專題—?jiǎng)?chuàng)傷性凝血病診治策略-wenkub
2024-11-05 01 本頁(yè)面
【正文】 f Trauma,是在嚴(yán)重創(chuàng)傷或大手術(shù)打擊下，機(jī)體出現(xiàn)以凝血功能障礙為主要表現(xiàn)(biǎoxi224。ngg249。nyīn)及機(jī)理：,1.血管內(nèi)皮細(xì)胞損傷，激活內(nèi)源性凝血系統(tǒng)(x236。ng)機(jī)制,6,第六頁(yè)，共二十九頁(yè)。ng)存在 有DIC 的臨床表現(xiàn) 實(shí)驗(yàn)室檢查 抗凝治療有效,7,第七頁(yè)，共二十九頁(yè)。)、灶性缺血性壞死、脫落及潰瘍形成，或不明原因的肺、腎、腦等臟器功能衰竭； 4. 抗凝治療有效。,一般(yībān)病例實(shí)驗(yàn)診斷 同時(shí)有下列三項(xiàng)以上異常： 1.PLT進(jìn)行性下降4.0g/L，或呈進(jìn)行性下降。,二、實(shí)驗(yàn)(sh237。)學(xué)會(huì)）,DIC 專業(yè)委員會(huì)根據(jù)體內(nèi)穩(wěn)定調(diào)節(jié)功能紊亂情況，將DIC 分為兩類： (1)非顯性DIC (NonOvert DIC)，指止血機(jī)制處于代償狀態(tài)(zhu224。,ISTH Diagnostic Scoring System for DIC,Scoring system for overt DIC Risk assessment: Does the patient have an underlying disorder known to be associated with overt DIC? If yes: proceed If no: do not use this algorithm Order global coagulation tests (PT, platelet count, fibrinogen, fibrin related marker) Score the test results ? Platelet count (100 109/l = 0, 3 but 6 s = 2) ? Fibrinogen level (1 g/l = 0, 1 g/l = 1) Calculate score: ≥5 compatible with overt DIC: repeat score daily 5 suggestive for nonovert DIC: repeat next 1–2 d,12,第十二頁(yè)
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