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首页> 外文期刊>Revista Cubana de Hematología, Inmunología y Hemoterapia >Coagulopat?-a Aguda Traum??tica y hemorragia masiva: una relaci?3n que debemos conocer
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Coagulopat?-a Aguda Traum??tica y hemorragia masiva: una relaci?3n que debemos conocer

机译：急性创伤性凝血病和大出血：我们必须知道的关系

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摘要

Accidents and different kind of injuries account for a relevant proportion of death causes from childhood to the fourth decade of life. Death from injury has increased by 20% over the last decade. Hemorrhages are estimated to cause between 30 to 70% of those deaths. Massive bleeding is also known for being one of the main causes of death during surgery in cases with extensive tissue damage from not traumatic origin. In around one third or more of such patients an acute traumatic coagulopathy or trauma associated coagulopathy is developed. This phenomenon obeys to complex, overlapping mechanisms which would be in its major part dependent on the event that caused the blood lost. This kind of coagulopathy can be defined as a functional reduction in clot strength with only minimal changes in clotting times. Its presence increases the risk of a massive bleeding, the use of larger volumes of blood components and the likelihood of dying by the hemorrhage. The early identification of acute traumatic coagulopathy through hemostatic tests such as TP/INR and viscoelastic assays as thrombelastography or rotational thrombelastometry modifies those risks since it brings a feasible therapeutic target to aim at, becoming the cornerstone for the newer transfusional strategies while facing massive bleedings.
机译：从童年到生命的第四十年，事故和不同类型的伤害在死亡原因中占相当大的比例。在过去十年中，因伤害而死亡的人数增加了20％。据估计，出血导致这些死亡的30％至70％。众所周知，大量出血是由于非创伤性​​起源引起的广泛组织损伤的手术中死亡的主要原因之一。在大约三分之一或更多的此类患者中，发生了急性外伤性凝血病或外伤相关性凝血病。这种现象服从复杂的，重叠的机制，这在很大程度上取决于导致血液流失的事件。这种凝结病可以定义为凝块强度的功能性降低，而凝血时间的变化却很小。它的存在增加了大出血的风险，大量血液成分的使用以及因出血而死亡的可能性。通过止血测试（例如TP / INR）和粘弹性测定（如血栓弹性描记术或旋转血栓弹性描记术）来早期识别急性创伤性凝血病，可改变这些风险，因为它带来了可行的治疗目标，成为面对大量出血时新型输血策略的基石。

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