DISORDERS OF HEMOSTASIS Dept of Hematology Zhong Shan Hospital, FuDan University Prof JIAN-MIN XU
DISORDERS OF HEMOSTASIS Dept.of Hematology ZhongShan Hospital,FuDan University Prof. JlAN-MIN XU
General Considerations Disorders of hemostasis defects in platelet number or function problems in fibrin clot(coagulation) Bleeding due to platelet disorders is typically mucosal or dermatologic include epistaxis, gum bleeding menorrhagia, gastrointestinal bleeding purpura, and petechiae
General Considerations • Disorders of hemostasis defects in platelet number or function problems in fibrin clot (coagulation) • Bleeding due to platelet disorders is typically mucosal or dermatologic include epistaxis, gum bleeding, menorrhagia, gastrointestinal bleeding, purpura, and petechiae
General Considerations Petechiae are seen almost exclusively in conditions of thrombocytopenia and not platelet dysfunction Bleeding due to coagulopathy may occur as deep muscle hematomas as well as skin bleeding Spontaneous hemarthroses are seen only in severe hemophilia
General Considerations • Petechiae are seen almost exclusively in conditions of thrombocytopenia and not platelet dysfunction. • Bleeding due to coagulopathy may occur as deep muscle hematomas as well as skin bleeding. • Spontaneous hemarthroses are seen only in severe hemophilia
General Considerations Definition disorder of hemostasis spontaneous bleeding abnormal bleeding following trauma Machanism vessel wall defect thrombocytopenia, platelet disfunction coagulation disorder
General Considerations • Definition: disorder of hemostasis spontaneous bleeding abnormal bleeding following trauma • Machanism ： vessel wall defect thrombocytopenia, platelet disfunction coagulation disorder
Normal hemostasis and coagulation hemostasis 1. Vessel wall (1)vessel spasm: reflex spasm SHT↑ slow down blood flow (2) subendothelial connective tissue encouraging platelet adhesion, activation aggregation (3)releasing TF, activating FXIl triggering intrinsic and extrinsic pathway (4) pression of haematoma
Normal hemostasis and coagulation • hemostasis: 1. Vessel wall： （1）vessel spasm: reflex spasm S-HT↑ slow down blood flow （2）subendothelial connective tissue： encouraging platelet adhesion, activation, aggregation （3）releasing TF, activating FⅫ： triggering intrinsic and extrinsic pathway （4）pression of haematoma