创伤性凝血病的发病机制十分复杂，具有多源性，涉及凝血系统的多个方面，其具体发生机制尚未完全明确。已知的发病机制主要有：稀释性凝血病、低温性凝血病、酸中毒性凝血病和消耗性凝血病等。对发病机制的新认识为临床创伤后凝血功能障碍的检测及治疗带来了新的改变。除常规实施“小容量复苏”和“允许性低血压”复苏的损伤控制性复苏策略外，近年来研究发现：对创伤低凝病人给予1∶1的新鲜冰冻血浆（FFP）与红细胞（RBC）大比例血浆输注，可大幅度降低出血病死率和总病死率；抗纤溶治疗是近年来创伤止血治疗的重要进展。

Posttraumatic coagulopathy: mechanism and clinical management        JIANG Dong-po, ZHOU Ji-hong. Daping Hospital & Research Institute of Surgery, the Third Military Medical University, Chongqing 400042, China
Corresponding  author ：ZHOU Ji-hong，E-mail：traumazjh@126.com
Abstract    The pathogenesis of coagulopathy of trauma is very complicated and it may be attributed to multiple sources including multiple factors of the coagulation system. However, the pathogenesis of coagulopathy of trauma has not been fully identified. The main known mechanisms of trauma-induced coagulopathy include dilution, hypothermia, acidemia and consumption etc.. The new knowledge about coagulopathy mechanisms has brought about new changes in the diagnosis and treatment of coagulopathy of trauma. In addition to the routine small volume resuscitation and permissive hypotension to resuscitate uncontrolled hemorrhagic shock, recent studies have shown that administration of fresh frozen plasma (FFP) and red blood cells (RBC) (with FFP/RBC ratio of 1:1) was associated with great reduction of both the hemorrhage-induced mortality rate and the total mortality rate of patients with traumatic coagulopathy. Moreover, antifibrinolytic therapy is another recent important advance in the management of bleeding in trauma patients.