外科理论与实践

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2023 , Vol. 28 >Issue 05: 425 - 431

DOI: https://doi.org/10.16139/j.1007-9610.2023.05.06

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黏弹性止血试验导向的创伤性凝血病诊治

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  • 同济大学附属东方医院重症医学科，上海 200120

收稿日期: 2023-07-21

  网络出版日期: 2024-01-04

基金资助

国家重点研发计划“干细胞及转化研究”重点专项(2019YFA0110601);上海市急危重症临床医学研究中心(21MC1930400)

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Viscoelastic hemostasis assay guided diagnosis and treatment of trauma-induced coagulopathy

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  • Department of Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai 200120, China

Received date: 2023-07-21

  Online published: 2024-01-04

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摘要

创伤性凝血病的诊治是严重创伤病人救治的重要一环。创伤性凝血病有创伤性高凝血症及创伤性低凝血症两种表型。创伤病人早期的凝血功能障碍表型多变。黏弹性止血试验能反映创伤病人凝血全貌，可以指导临床医师快速识别创伤性凝血病的不同表型，并针对不同凝血指标障碍进行精细化管理。本文介绍了黏弹性止血试验常见的检测方式及其原理，并结合当前国内外文献报道，总结了不同分型下的创伤性凝血病的基于黏弹性止血试验的诊断及治疗方法，以期给广大临床医师提供临床诊治思路。

关键词： 黏弹性止血试验; 创伤性凝血病; 创伤; 血栓弹力图; 高凝血症

本文引用格式

沈拓, 朱峰 . 黏弹性止血试验导向的创伤性凝血病诊治[J]. 外科理论与实践, 2023 , 28(05) : 425 -431 . DOI: 10.16139/j.1007-9610.2023.05.06

Abstract

The diagnosis and treatment of trauma-induced coagulopathy is an important part of the treatment of severe trauma patients. Trauma-induced coagulopathy has two phenotypes: hypercoagulability and hypocoagulability. The phenotype of coagulopathy in the early stage of trauma patients is variable. Viscoelastic hemostatic assay can reflect the full picture of coagulation in trauma patients. It can guide clinicians to quickly identify different phenotypes of trauma-induced coagulopathy, and fine manage different phenotypes of coagulopathy. This paper introduced the detection methods and principles of common viscoelastic hemostasis assays, and summarized the diagnosis and treatment methods based on viscoelastic hemostasis assay in different phenotypes of trauma-induced coagulopathy from literature, aimed to provide elicitation of diagnosis and treatment for clinicians.

Key words： Viscoelastic hemostasis assay; Trauma-induced coagulopathy; Trauma; Thromboelastography; Hypercoagulability

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