关键词: 创伤, 凝血障碍, 创伤性凝血病

Abstract:

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.

Key words: trauma, coagulopathy, traumatic coagulopathy