局限性血管内凝血诊断与治疗中国专家共识

doi:10.19438/j.cjoms.2024.04.001

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (4): 313-321.doi: 10.19438/j.cjoms.2024.04.001

局限性血管内凝血诊断与治疗中国专家共识

邰茂众^1,*, 秦中平^1#, 郑家伟^2#, 李克雷^1,*, 刘学键^3,*, 李凯^4#, 袁斯明⁵, 范新东⁶, 周德凯⁷, 董长宪⁸, 吉毅⁹, 顾松¹⁰, 霍然¹¹, 杨耀武¹², 王绪凯¹³

1.山东省临沂市肿瘤医院省级血管瘤特色专科,山东临沂 276001;
2.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科,上海 200011;
3.山东省第一康复医院肿瘤科,山东临沂 276000;
4.复旦大学附属儿科医院普外科,上海 201102;
5.南京大学医学院附属金陵医院（中国人民解放军东部战区总医院）烧伤整形科,江苏南京 210002;
6.上海交通大学医学院附属第九人民医院介入科,上海 200011;
7.重庆医科大学附属儿童医院胃肠新生儿外科血管瘤专科,重庆 400014;
8.河南省人民医院·郑州大学人民医院·河南大学人民医院血管瘤科,河南郑州 450003;
9.四川大学华西医院小儿外科, 四川成都 610041;
10.上海交通大学附属上海儿童医学中心肿瘤外科,上海 200127;
11.山东第一医科大学附属省立医院·医学科技创新中心整形美容外科,山东济南 250021;
12.空军军医大学第三附属医院颌面头颈肿瘤科,陕西西安 710032;
13.中国医科大学口腔医学院·附属口腔医院口腔颌面外科,辽宁沈阳 110002

收稿日期:2023-03-20 修回日期:2023-04-10 出版日期:2024-07-20 发布日期:2024-08-07
通讯作者: 秦中平,E-mail: qinzhongping1962@163.com;郑家伟,E-mail: davidzhengjw@hotmail.com;李凯,E-mail: likai2727@163.com。^#共同通信作者
作者简介:邰茂众(1982-),男,在读博士研究生,副主任医师,E-mail: doudebao@163.com;李克雷（1971-）,男,硕士,主任医师,E-mail: likelei@sina.com;刘学键（1970-）,男,硕士,主任医师,E-mail: yhl_228@sina.com。^*并列第一作者

Chinese expert consensus on diagnosis and treatment of localized intravascular coagulopathy

TAI Mao-zhong¹, QIN Zhong-ping¹, ZHENG Jia-wei², LI Ke-lei¹, LIU Xue-jian³, LI Kai⁴, YUAN Si-ming⁵, FAN Xin-dong⁶, ZHOU De-kai⁷, DONG Chang-xian⁸, JI Yi⁹, GU Song¹⁰, HUO Ran¹¹, YANG Yao-wu¹², WANG Xu-kai¹³

1. Special Department of Vascular Anomalies, Tumor Hospital of Linyi City. Linyi 276001, Shandong Province;
2. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
3. Department of Oncology, First Rehabilitation Hospital of Shandong. Linyi 276000, Shandong Province;
4. Department of Pediatric Surgery, Children's Hospital of Fudan University. Shanghai 201102;
5. Department of Burn and Plastic Surgery, General Hospital of Eastern Theater Command,PLA-Jinling Hospital, Medical School of Nanjing University. Nanjing 210002, Jiangsu Province;
6. Department of Intervention Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
7. Department of Infantile Hemangioma, Gastrointestinal and Neonatal Surgery, Children's Hospital of Chongqing Medical University. Chongqing 400014;
8. Department of Hemangioma, Henan Provincial People’s Hospital. Zhengzhou 450003, Henan Province;
9. Department of Pediatric Surgery, West China Hospital, Sichuan University. Chendu 610041, Sichuan Province;
10. Department of Pediatric Oncologic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine. Shanghai 200127;
11. Department of Plastic and Esthetic Surgery, Medical Science and Technology Innovation Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University. Jinan 250021, Shandong Province;
12. Department of Maxillofacial Head and Neck Oncology, Air Force Medical University of PLA. Xi'an 710032, Shaanxi Province;
13. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University. Shenyang 110002, Liaoning Province, China

Received:2023-03-20 Revised:2023-04-10 Online:2024-07-20 Published:2024-08-07

摘要/Abstract

摘要： 局限性血管内凝血（localized intravascular coagulopathy, LIC）特指静脉畸形(venous malformations, VMs)合并血栓形成、出血等凝血功能障碍表现,表现为D二聚体（D-dimer, DD）水平异常升高,伴或不伴纤维蛋白原（fibrinogen, FIB）减少,一般不伴血小板减少。LIC可并发急性疼痛、大出血、关节挛缩畸形等,目前对其诊断和治疗尚存在分歧。为提高国内同行的认识和诊疗水平,规范临床治疗,我们组织国内相关学科专家制定本专家共识。该共识对LIC的发生机制、临床表现、诊断方法和治疗流程给出了指导性建议,以供临床实践参考。

关键词: 静脉畸形, 局限性血管内凝血, D二聚体, 纤维蛋白原, 专家共识

Abstract: Localized intravascular coagulopathy(LIC) refers to coagulation disorders such as thrombosis and bleeding that occurred in venous malformations(VMs). It is characterized by abnormally elevated D-dimer(DD) levels, with or without decreased fibrinogen(FIB), and generally without thrombocytopenia. LIC can be complicated with acute pain, excessive bleeding, arthrogryposis, etc. Controversies in its diagnosis and treatment still existed. In order to improve the diagnosis and standardize treatment of LIC in China, we invited relevant experts to discuss and formulate Chinese expert consensus. The consensus provides standardized suggestions on the pathogenesis, clinical manifestations, diagnostic methods and treatment process of LIC, which can provide reference for clinical practice.

Key words: Venous malformations, Localized intravascular coagulopathy, D-dimer, Fibrinogen, Expert consensus

中图分类号:

R543.6

邰茂众, 秦中平, 郑家伟, 李克雷, 刘学键, 李凯, 袁斯明, 范新东, 周德凯, 董长宪, 吉毅, 顾松, 霍然, 杨耀武, 王绪凯. 局限性血管内凝血诊断与治疗中国专家共识[J]. 中国口腔颌面外科杂志, 2024, 22(4): 313-321.

TAI Mao-zhong, QIN Zhong-ping, ZHENG Jia-wei, LI Ke-lei, LIU Xue-jian, LI Kai, YUAN Si-ming, FAN Xin-dong, ZHOU De-kai, DONG Chang-xian, JI Yi, GU Song, HUO Ran, YANG Yao-wu, WANG Xu-kai. Chinese expert consensus on diagnosis and treatment of localized intravascular coagulopathy[J]. China J Oral Maxillofac Surg, 2024, 22(4): 313-321.

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局限性血管内凝血诊断与治疗中国专家共识

Chinese expert consensus on diagnosis and treatment of localized intravascular coagulopathy

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