儿童脓毒症相关性弥散性血管内凝血诊疗研究进展

Diagnosis and treatment of sepsis associated disseminated intravascular coagulation in children

脓毒症相关性弥散性血管内凝血是脓毒症常见的并发症,是儿科重症监护病房死亡率增加的重要原因之一。脓毒症发生时炎症因子风暴会引起机体多种组织器官损伤,而其并发症弥散性血管内凝血会进一步加剧机体的器官功能障碍。因此,弥散性血管内凝血的早期检测在儿童脓毒症治疗中至关重要,自日本卫生福利部于1983年提出第一个诊断标准后,近年来相继有新的诊断标准提出。同时,及时的诊断有助于早期干预,改善预后,故各种治疗方案相继出现。该文对脓毒症相关性弥散性血管内凝血诊断标准的创建历史和优缺点,以及各种抗凝制剂和抗凝疗法的研究进展作一综述。

Sepsis associated disseminated intravascular coagulation is a common complication of sepsis and one of the major causes of increased mortality in pediatric intensive care units.When sepsis occurs,the inflammatory factor storm will cause damage to various tissues and organs of the body,and its complication DIC will further aggravate the organ dysfunction.Therefore,the early detection of DIC is crucial in the treatment of sepsis in children.Since the first diagnostic criteria were proposed by the ministry of health and welfare of Japan(JMHW)in 1983,new diagnostic criteria have been proposed in recent years.At the same time,timely diagnosis is helpful for early intervention to improve the prognosis,so a variety of treatment schemes have also emerged.This article reviews the establishing history,advantages and disadvantages of the diagnostic criteria for sepsis associated DIC,as well as the research progress on various anticoagulants and anticoagulant therapies.