弥散性血管内凝血的实验室检查方法与临床意义

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弥散性血管内凝血(DIC)是由许多病因所引起的一组严重出血综合征,其诱发因素很多,以产科并发症引起者最常见。由于基础疾病不同和病情的发展缓急不一,DIC的临床表现很不一致,可分为急性型、亚急性型及慢性型三类。广泛性自发性出血是DIC最突出的症状,继而出现微循环障碍、微血管栓塞或微血管性溶血。DIC的临床表现变化较大,临床症状和体征不一定都同时出现,而且导致DIC的基础疾病不同,因而增加了临床上及时诊断的难度,往往需要依靠实验室检查,才能作出正确判断。目前认为有助于DIC诊断的生物化学检查,主要着重于出血倾向方面,即消耗性凝血障碍和继发性纤溶两大类。 1 反映凝血活性和消耗性凝血因子及血小板的检查 1.1 血小板计数:血小板离体后易受外界温度、酸碱度、容器表面性质等的影响而变形或破坏,血小板具有 Disseminated intravascular coagulation (DIC) is a group of severe hemorrhagic syndromes caused by many etiologies that are predisposed to many factors and are most often caused by obstetric complications. Due to the different underlying diseases and the development of the disease, the clinical manifestation of DIC is very inconsistent and can be divided into acute type, subacute type and chronic type. Extensive spontaneous bleeding is the most prominent symptom of DIC, followed by microcirculation, microvascular embolism or microvascular hemolysis. DIC clinical manifestations of changes in clinical symptoms and signs are not necessarily all occur at the same time, and lead to different underlying diseases of DIC, thus increasing the difficulty of clinical timely diagnosis often rely on laboratory tests to make the right judgments. Biochemical tests that are currently believed to contribute to the diagnosis of DIC are mainly focused on bleeding tendencies, namely consumptive coagulopathy and secondary fibrinolysis. 1 reflect the coagulation activity and consumption of coagulation factors and platelet examination 1.1 platelet count: Platelet ex vivo vulnerable to external temperature, pH, the nature of the container surface deformation or destruction, the platelet has
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