@article{oai:niigata-u.repo.nii.ac.jp:00019825,
 author = {吉川, 恵次 and 佐藤, 一範 and 本多, 忠幸 and 斎藤, 憲},
 issue = {10},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Oct},
 note = {The purpose of the present study is to clarify what is the most common mechanism of eliciting coagulation abnormalities in massively transfused trauma patients, and to clarify the relationship between such abnormalities and the development of post-traumatic jaundice. A retrospective analysis was made of the charts of 8 trauma patients （ISS: 18～36, median; 26.5） treated at Emergency and Critical Care Unit, Niigata University Hospital. i） Significant negative correlation between the nadir value of the blood platelet count （usually seen on the 2nd post-injury day） and the total replaced blood volume was observed. In addition, cumulative balance between the volume of administered fluid and urine during the time from injury to 6:00 am, 2nd post-injury day tended to negatively correlate with the nadir value. ii） Only slight prolongation of the PT, APTT was seen in patients receiving massive transfusion during the early post-injury day. iii） Specific parameters of DIC, such as FDP, TAT, D-Dimer etc., were markedly elevated in all patients transfused more than 10,000 ml. iv） Marked post-traumatic jaundice was observed in 3 out of 4 massively transfused patients, in whom prolonged shock after the injury and the DIC in the early post-injury period were commonly seen. Conclusion. 1） Bleeding tendency in post-traumatic patients after massive transfusion is mainly caused by dilutional thrombocytopenia （DT） and disseminated intravascular coagulation （DIC）. Unlikely contribution of the dilutional coagulopathy （DC: due to the dilution of clotting factors by fluid infused） to the disorder is suggested. 2） Contribution of the prolonged shock during the immediate post-injury period to the profound post-traumatic jaundice in massively transfused patients was shown. Role of the DIC commonly seen in such patients in eliciting the jaundice has to be clarified.},
 pages = {896--910},
 title = {大量輸血後の多発外傷患者における出血凝固異常および外傷後黄疸に関する検討},
 volume = {107},
 year = {1993}
}