创伤性凝血病诊断策略研究进展

Research progress in diagnostic strategies of trauma-induced coagulopathy

创伤是中青年人群死亡和残疾的首要病因,创伤性大出血及创伤性凝血病(TIC)是创伤患者的主要死因,是潜在可预防和改善的。既往研究中TIC虽有诊断指标,但其复杂的发病机制、多种检测方法及其指标之间差异,导致其未形成统一、明确的诊断指南和专家共识。这不仅影响TIC的早期诊断与早期发现,也造成对TIC及时规范治疗的延迟。目前,TIC诊断与评估包括传统凝血功能检测、凝血因子测试、全血黏弹性试验等实验室检测,还包括预测评分等多种诊断策略。笔者通过查阅文献,围绕TIC的诊断策略进行综述,以期为TIC的标准化评估提供一定的参考。

Trauma is the leading cause of death and disability for young and middle-aged people.Uncontrolled traumatic bleeding and trauma-induced coagulopathy(TIC)are potentially preventable causes of death in major traumatic patients.Although there are some diagnostic indicators for TIC in previous studies,unified and clear diagnostic guidelines and expert consensus have not been issued due to its complex pathogenesis,various detective methods and differences of indicators.Early diagnosis and detection of TIC cannot be achieved efficiently,which also results in the delay of standardized treatment of TIC.Currently,the diagnostic assessments of TIC include various laboratory tests such as conventional coagulation tests,coagulation factors tests,whole blood viscoelastography tests and other diagnostic strategies such as predictive scoring systems.Through literature review,the authors mainly summarize diagnostic strategies of TIC,aiming at providing some professional references for standardized assessment of TIC.