Activation of the clotting system and complement after trauma.
Activation of the clotting system and complement after trauma.
复制标题
创伤后凝血系统和补体的激活。
DOI：
--
复制
发表时间：
1996
期刊：
影响因子：
--
通讯作者：
D. Dries
中科院分区：
文献类型：
--
作者：
D. Dries
传统的方法止血障碍的受伤病人已经集中在出血，而不是高凝状态。尽管有越来越多的证据表明，其他患者群体中的凝血障碍是由于凝血不当而非出血导致的器官功能丧失，但这种策略仍在继续。虽然传统的检测在筛查低水平凝血因子或血小板功能障碍时是有用的，但只有明显的出血或显著的纤维蛋白溶解才能被识别出来。细胞间的相互作用，特别是血管内皮的相互作用，不被这些测定考虑在内。重症感染患者出现凝血功能异常已超过20年。尽管在败血症中认识到这种关联，但我们才刚刚开始了解凝血异常是如何在损伤中发展的，并考虑对抗它们的策略。虽然创伤后出血可以成功治疗，但微循环血栓形成往往会导致终末器官损伤，并伴有不可逆的缺血性改变，可能导致死亡。
The traditional approach to hemostatic disorders in the injured patient has focused on bleeding rather than a hypercoagulable state. This strategy continues despite growing evidence from studies of coagulation disorders in other patient groups highlighting loss of organ function secondary to inappropriate coagulation rather than hemorrhage. While traditional testing is useful in screening for low levels of coagulation factors or platelet dysfunction, only obvious bleeding or significant fibrinolysis is identified. Cellular interactions, in particular those of the vascular endothelium, are not taken into account by these assays. More than 20 years have passed since coagulation abnormalities were reported in patients with severe infection. Despite recognition of this association in sepsis, we are only beginning to understand how coagulation abnormalities develop in injury and to consider strategies to counter them. While hemorrhage may be successfully treated in patients following trauma, thrombosis in the microcirculation often contributes to end-organ damage with irreversible ischemic changes that may lead to death.