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血凝酶在急性出血性疾病中应用的专家共识

2018-02-07 国内急诊/重症相关专家小组（统称） 中华急诊医学杂志.2018,27(2):137-140.

血凝酶急性出血性疾病

出血性疾病是急诊常见病，每年约有15％~20％的患者因各种原因导致的出血而就诊于急诊科，包括急性创伤性出血、非创伤性出血和手术及侵人性操作导致的出血。临床处理主要包括手术、介人治疗、直接压迫以及药物止血。常用的止血药物主要包括：①作用于血管及血管壁类药物，如垂体后叶素、卡络磺钠等；②作用于血小板类药物，如酚磺乙胺（ethamsylate)；③促进凝血系统功能类药物，如新鲜冰冻血浆（FFP）、人凝血

中文标题：

血凝酶在急性出血性疾病中应用的专家共识

发布机构：

国内急诊/重症相关专家小组（统称）

发布日期：

2018-02-07

简要介绍：

出血性疾病是急诊常见病，每年约有15％~20％的患者因各种原因导致的出血而就诊于急诊科，包括急性创伤性出血、非创伤性出血和手术及侵人性操作导致的出血。临床处理主要包括手术、介人治疗、直接压迫以及药物止血。常用的止血药物主要包括：①作用于血管及血管壁类药物，如垂体后叶素、卡络磺钠等；②作用于血小板类药物，如酚磺乙胺（ethamsylate)；③促进凝血系统功能类药物，如新鲜冰冻血浆（FFP）、人凝血酶原复合物（Prothrombin complexcon centrate,PCC）、重组活化因子妞（rF Ⅶa）、纤维蛋白原（fibrinogen）、血凝酶等；④抗纤维蛋白溶解类药物，如氨甲环酸。

目前，一些止血药物临床应用疗效评价缺乏足够的证据，且有潜在增加血栓风险的可能，受到越来越多的质疑。而血凝酶由于其特有的机制，不仅可以有效止血，而且具有在正常血管系统中不引起血栓形成的特点，逐渐为临床医生所重视。本共识关注血凝酶在急性出血性疾病中的临床应用。

 

拓展指南：与出血相关指南：

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  1. [GetPortalCommentsPageByObjectIdResponse(id=955026, encodeId=28d1955026ae, content=学习到了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61825477888, createdName=ms3000001426915494, createdTime=Wed Apr 07 19:52:45 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305139, encodeId=10ed30513903, content=好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59181997370, createdName=zltifn, createdTime=Thu Apr 12 18:26:27 CST 2018, time=2018-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288925, encodeId=04e128892502, content=学习了不少事情!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Sun Feb 18 13:35:30 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288346, encodeId=8dde28834665, content=非常好.学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Feb 16 07:46:50 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288305, encodeId=fb7f2883050e, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Fri Feb 16 05:22:57 CST 2018, time=2018-02-16, status=1, ipAttribution=)]
    2021-04-07 ms3000001426915494

    学习到了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=955026, encodeId=28d1955026ae, content=学习到了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61825477888, createdName=ms3000001426915494, createdTime=Wed Apr 07 19:52:45 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305139, encodeId=10ed30513903, content=好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59181997370, createdName=zltifn, createdTime=Thu Apr 12 18:26:27 CST 2018, time=2018-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288925, encodeId=04e128892502, content=学习了不少事情!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Sun Feb 18 13:35:30 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288346, encodeId=8dde28834665, content=非常好.学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Feb 16 07:46:50 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288305, encodeId=fb7f2883050e, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Fri Feb 16 05:22:57 CST 2018, time=2018-02-16, status=1, ipAttribution=)]
    2018-04-12 zltifn

    好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=955026, encodeId=28d1955026ae, content=学习到了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61825477888, createdName=ms3000001426915494, createdTime=Wed Apr 07 19:52:45 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305139, encodeId=10ed30513903, content=好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59181997370, createdName=zltifn, createdTime=Thu Apr 12 18:26:27 CST 2018, time=2018-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288925, encodeId=04e128892502, content=学习了不少事情!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Sun Feb 18 13:35:30 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288346, encodeId=8dde28834665, content=非常好.学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Feb 16 07:46:50 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288305, encodeId=fb7f2883050e, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Fri Feb 16 05:22:57 CST 2018, time=2018-02-16, status=1, ipAttribution=)]
    2018-02-18 圣艮山

    学习了不少事情!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=955026, encodeId=28d1955026ae, content=学习到了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61825477888, createdName=ms3000001426915494, createdTime=Wed Apr 07 19:52:45 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305139, encodeId=10ed30513903, content=好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59181997370, createdName=zltifn, createdTime=Thu Apr 12 18:26:27 CST 2018, time=2018-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288925, encodeId=04e128892502, content=学习了不少事情!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Sun Feb 18 13:35:30 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288346, encodeId=8dde28834665, content=非常好.学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Feb 16 07:46:50 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288305, encodeId=fb7f2883050e, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Fri Feb 16 05:22:57 CST 2018, time=2018-02-16, status=1, ipAttribution=)]
    2018-02-16 swfzhanggui

    非常好.学习了.谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=955026, encodeId=28d1955026ae, content=学习到了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61825477888, createdName=ms3000001426915494, createdTime=Wed Apr 07 19:52:45 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=305139, encodeId=10ed30513903, content=好多错误啊.部分内容和引用文献对不上.参考文献标到39.但后面只有35个.13号参考文献和22号重复.这让我们怎么相信啊-, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59181997370, createdName=zltifn, createdTime=Thu Apr 12 18:26:27 CST 2018, time=2018-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288925, encodeId=04e128892502, content=学习了不少事情!, beContent=null, objectType=guider, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Sun Feb 18 13:35:30 CST 2018, time=2018-02-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288346, encodeId=8dde28834665, content=非常好.学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/21/9461f3b3c9f14e1d844256cdd08f2cf3.jpg, createdBy=a30f1426910, createdName=swfzhanggui, createdTime=Fri Feb 16 07:46:50 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=288305, encodeId=fb7f2883050e, content=学习了, beContent=null, objectType=guider, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Fri Feb 16 05:22:57 CST 2018, time=2018-02-16, status=1, ipAttribution=)]
    2018-02-16 121832a9m88暂无昵称

    学习了

    0

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