20xx年醫(yī)學專題—創(chuàng)傷性凝血病診治策略-wenkub
2024-11-05 01 本頁面
【正文】 f Trauma,是在嚴重創(chuàng)傷或大手術打擊下，機體出現(xiàn)以凝血功能障礙為主要表現(xiàn)(biǎoxi224。ngg249。nyīn)及機理：,1.血管內皮細胞損傷，激活內源性凝血系統(tǒng)(x236。ng)機制,6,第六頁，共二十九頁。ng)存在 有DIC 的臨床表現(xiàn) 實驗室檢查 抗凝治療有效,7,第七頁，共二十九頁。)、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)病例實驗診斷 同時有下列三項以上異常： 1.PLT進行性下降4.0g/L，或呈進行性下降。,二、實驗(sh237。)學會）,DIC 專業(yè)委員會根據(jù)體內穩(wěn)定調節(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
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