弥散性血管内凝血cade

J. Cade
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摘要

弥散性血管内凝血(DIC)是一种血小板-纤维蛋白血栓在微循环中沉积的综合征,伴随着血小板和凝血因子的消耗,可能的临床特征是出血或血栓形成,或两者兼而有之。它可能由凝血激活、血小板聚集或内皮损伤产生。它不是一种原发疾病,而是许多严重疾病的常见和重要并发症,特别是败血症、癌症和产科事故。休克和酸中毒是常见的诱发因素,维生素K缺乏是常见的并发症。DIC通常无临床表现,但可引起出血、缺血性器官损伤或休克。尽管DIC的临床贡献往往难以与潜在疾病分开,但DIC仍然是急性患者全身性出血倾向的最常见原因。实验室确认包括血小板减少症、凝血功能障碍、低纤维蛋白原血症、纤维蛋白降解产物水平升高和凝血试验阳性结果。最重要的治疗措施是控制基础疾病,但可能需要替代治疗和肝素,特别是如果出血明显,过程不是急性和自限性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DISSEMINATED INTRAVASCULAR COAGULATION CADE
Disseminated intravascular coagulation (DIC) is a syndrome of deposition of platelet-fibrin thrombi in the microcirculation, with consumption of platelets and clotting factors and possible clinical features of bleeding or thrombosis or both. It may be produced by activation of coagulation, platelet aggregation or endothelial damage. It is not a primary disease, but a common and important complication of many serious illnesses, especially sepsis, carcinoma and obstetrical accidents. Shock and acidosis are frequent precipitating factors, and vitamin K deficiency is a common complicating factor. DIC usually produces no clinical features, but it may give rise to bleeding, ischcemic organ damage or shock. Although its clinical contribution is often difficult to separate from that due to the underlying disease, DIC remains the commonest cause of a generalized bleeding tendency in acutely sick patients. Laboratory confirmation consists of the demonstration of thrombocytopenia, coagulation impairment, hypofibrinogenamia, raised levels of fibrin degradation products, and positive results of para-coagulation tests. The most important therapeutic measure is control of the underlying disease, but replacement therapy and heparin may be required, especially if bleeding is significant and the process is not acute and self-limited.
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