患儿男，6岁，2天前有严重车祸撕脱伤，现 患儿体温38.5°C，四肢凉，全身多处皮肤瘀斑及 出血点，伴黄疸，血红蛋白尿，BP 60/35mmHg, 査血小板计数55X109/L,纤维蛋白原1. 2g/L, 肝功能正常。与该患儿出血关系最为密切的因素是

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