CAJ | 학술논문

弥散性血管内凝血( DIC)是一个非常复杂的病理生理过程，促凝和抗凝因子及血小板均有消耗，根据临床表现和实验室检查很难准确判断疾病的真实临床进程，处理上常常需要结合所在医院习惯和专家的经验。不同类型DIC的处理、用药的剂量与方案存在诸多的不确定性。有关DIC的治疗，儿科目前主要参考成人的指南。DIC最重要的处理措施是对潜在疾患进行强有力的治疗，消除触发凝血病变危险因素，同时采用恰当的血液制品进行复苏。尚无临床随机试验证实应用肝素在DIC患者能改善临床相关结果，活化蛋白C、抗凝血酶、组织因子通路抑制物和血栓调节素等抗凝因子在DIC治疗中的意义还有待于更多高质量的临床研究深入探讨。
미산성혈관내응혈( DIC)시일개비상복잡적병리생리과정，촉응화항응인자급혈소판균유소모，근거림상표현화실험실검사흔난준학판단질병적진실림상진정，처리상상상수요결합소재의원습관화전가적경험。불동류형DIC적처리、용약적제량여방안존재제다적불학정성。유관DIC적치료，인과목전주요삼고성인적지남。DIC최중요적처리조시시대잠재질환진행강유력적치료，소제촉발응혈병변위험인소，동시채용흡당적혈액제품진행복소。상무림상수궤시험증실응용간소재DIC환자능개선림상상관결과，활화단백C、항응혈매、조직인자통로억제물화혈전조절소등항응인자재DIC치료중적의의환유대우경다고질량적림상연구심입탐토。
Disseminated intravascular coagulation ( DIC ) is a exceedingly complicated pathophysiological process,both pro and anti coagulation factors are activated and consumed,it is difficult to determine acute stage of the syndrome for physicians based on clinical presentations and laboratory tests,management strategy of DIC is not same due to different etiology,the dose and regimen of drug administration are uncertain. At present pediatricians usually treat children patients with DIC according to researches and guidelines for adults. The key strategies to DIC management is to treat underlying diseases aggressively so as to clear risk factors triggering extensive coagulation and resuscitate with ap-propriate blood products. No clinical trials have proved that heparin can improve clinical outcome,efficacies of activated protein C,antithrombin, tissue factor pathway inhibitor and thrombomodulin are needed to be verified by more high qua-lity clinical trials in DIC treatment.