凝血机制障碍是外科危重病人术中出血无法控制和死亡的重要原因。低体温和机体代谢性酸中毒与创伤致凝血机制障碍密切相关，并与之相互促进，形成致死三联征，导致机体状况迅速恶化。正确认识严重创伤及外科大手术病人的上述病理生理改变，是损伤控制性外科和损伤控制性复苏实施的理论基础。

Hypothermia, acidosis and coagulopathy    GONG Jian-feng，ZHU Wei-ming . Research Institute of General Surgery，Clinical School of Medicine, Nanjing University, Nanjing General Hospital of Nanjing Military Command，PLA，Nanjing 210002，China
Corresponding author：ZHU Wei-ming，E-mail：juwiming@yahoo.com.cn
Abstract    Coagulopathy is a life threatening complication in trauma patients who have sustained significant injuries and blood loss. Its association with hypothermia and metabolic acidosis is common and constitutes a vicious cycle, causing a “lethal triad”. The most important treatment of hypocoagulability is the avoidance or rapid reversal of the lethal triad, which has been the theoretical basis for the application of damage control surgery (DCS) and damage control resuscitation (DCR) techniques in patients with severe trauma.