文档介绍：北京大学人民医院
急诊科
弥散性血管内凝血
Disseminated Intravascular Coagulation
北京大学人民医院
急诊科朱继红
2019/3/10
血栓形成机制
Hypercoagulability
Stasis
Vessel Injury
Rudolf Virchow (1821-1902)
血栓、栓塞、纤维蛋白原”的命名人德国的 Rudolf virchow教
授于1856年提出血栓形成三大要素:血管壁损伤、血流异常、血液
成分异常。该理论至今仍被认可。
士“月:。世茅直在口
ISTH- Leads a Coalition- of- Medical Organizations
from Around the World to Launch First-Everi
World Thrombosis Day.
Isth
Ⅰ STHSSO对DIC的定义
DIC是由不同原因引起的以失控的血管内凝血激活(纤维
蛋白产物生成)为特征的一种获得性综合征。它起源于微
血管系统并造成徼血管系统损害,严重时造成脏器功能失
常
DIC is an acquired syndrome characterised by the
intravascular activation of coagulation with loss of
localisation arising from different causes. It can originate
from and cause damage to the microvasculature, which if
sufficiently severe can produce organ dysfunction
Thromb haemost 2001: 86: 1327-30
2019/3/10
DIC的病因
急性感染
>妊娠并发症
>恶性肿瘤
血液疾病
>大量组织损伤
Clinical conditions associated with dIc
Causative factor organisms/conditions attributable to DIc
Infections
Bacterial -Sepsis by Gram-negative bacill
Gram-positive CoccI
Viral -CMV, HIv, hepatitis, dengue
Fungal - Invasive pulmonary aspergillosis
Parasitic-Malaria, leptospirosis
Rickettsial
Malignancy
Solid tumours- Adenocarcinoma of pancreas
prostate
Haematological- AML-M3
Obstetric
Amniotic fluid embolism
Abruptio placentae
lampson
Dead foetus syndrome
Retained products of pl
Toxic and
Viper snake bites
Clinical conditions associated with dIc
Causative factor Organisms/conditions attributable to DIC
immunological
Massive transfusion
insults
ABO transfusion incompatibility
Graft versus host disease
Massive
Severe trauma, crush injuries, massive burns
flammation
severe hypo-hyperthermia, severe pancreatitis
gunshot brain injury
Vascular
Aortic aneurysms
disorders
Giant haemangiomas
(Kasabach-Merritt syndrome)
Liver diseases Fulminant hepatic failure, fatty liver of pregnancy
Underlying disease associated with DIC
JMHW 1998
High absolute High frequency