《创伤性高凝血症诊疗中国专家共识》解读

The interpretation of Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy

创伤性高凝血症是创伤性凝血病(TIC)以血液高凝状态为主要特征的表型,具有血管内皮损伤、促凝物质过度释放、高纤维蛋白原血症、血小板高反应性、抗凝机制受损、纤溶抑制等多种特征性血凝学改变。近年来研究发现,随着创伤严重程度的不同,创伤性高凝血症的发生率、致死率和致残率亦不相同。因此,全军重症医学专业委员会与中国医药教育协会血栓与止血危重病专业委员会共同制定了《创伤性高凝血症诊疗中国专家共识》,该共识2021年4月发表于Military Medical Research[《军事医学研究(英文)》杂志]。该文从创伤性高凝血症的定义、病理生理机制、评估、预防及治疗等五个方面对该共识的主要内容进行解读。

Trauma-induced hypercoagulopathy is a hypercoagulable phenotype of trauma-induced coagulopathy(TIC)characterized by vascular endothelial injury,excessive release of procoagulants,hyperfibrinogenemia,platelet hyperactivity,anticoagulant pathways impairment and fibrinolysis shutdown.Recent studies have found that the incidence,mortality and disability rate of trauma-induced hypercoagulopathy increased significantly with the severity of trauma.Therefore,the People’s Liberation Army Professional Committee of Critical Care Medicine and China Medical Education Association Professional Committee of Thrombosis,Hemostasis and Critical Care Medicine jointly formulated Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy published in Military Medical Research in April,2021.In present paper,the main contents of the consensus were interpreted from the definition,pathophysiological mechanism,assessment,prevention,and treatment of trauma-induced hypercoagulopathy.