脓毒症相关的凝血障碍

Sepsis-related coagulopathy

弥散性血管内凝血（disseminated intravascular coagulation，DIC）是重症领域具有挑战性的综合征，临床诊断相对困难，不同患者的治疗决策迥异。脓毒症诱导的DIC是炎症与凝血系统互相对话相互作用的复杂病理生理过程，因此治疗较为困难。诊断可依据DIC评分系统，治疗以综合治疗为主，包括抗生素合理使用及病灶清除，以及凝血障碍的纠正，防止病情进展和器官功能衰竭。

Disseminated intravascular coagulation（DIC） remains a challenging syndrome for intensivists, as the markers enabling its identification are lacking, and the treatment is patient dependent. The process underlying DIC is a complex interlinked framework of proteases of both the coagulation and inflammatory cascades, thus explaining the difficulty in DIC management. Identification can be accomplished with scoring systems such as the DIC score, and treatment begins with identification and treatment of the underlying infec- tious cause. Supportive care and correction of coagulopathies should be provided simultaneously to prevent irreversible end-organ injury and DIC progression.