脓毒症合并弥散性血管内凝血的机制与监测

摘要

Sepsis-induced disseminated intravascular coagulation (DIC) is a severe and relatively common disorder with high mortality in intensive care units.Sepsis at the early stage is usually manifested as hypercoagulable, while septic DIC as hypocoagulable.This article focuses on the pathophysiological mechanisms of septic DIC in the aspects up-regulation of procoagulant pathways, impairment of physiological anticoagulant mechanism, and suppression of fibrinolysis.It also gives a brief introduction to the application of thromboelastography in the diagnosis of septic DIC.%脓毒症合并弥散性血管内凝血是一种病死率较高的常见危重症.脓毒症初期常表现为高凝状态,一旦伴发弥散性血管内凝血就会表现为低凝状态.文中从促凝途径功能上调、生理性抗凝机制受损和纤溶系统抑制3个方面阐述脓毒症合并弥散性血管内凝血的病理生理研究进展,并简要介绍应用全血凝血功能检测设备判断脓毒症合并弥散性血管内凝血时凝血状态的方法.