新生儿弥漫性血管内凝血早期诊治探讨(附28例临床分析)

PROBE INTO THE EARLY DIAGNOSIS AND TREATMENT OF NEONATAL DISSEMINATED INTRAVASCULAR COAGULATION: AN ANALYSIS OF 28 CASES

本文通过分析28例新生儿DIC的诊治经验以探索早期诊治方法。以BPC、PT、FJB为基本过筛试验，三项阳性或其中二项阳性则加CT、APTT、3P或FDP、外周血破碎红细胞0．02以上几项中一项以上阳怀，密切结合临床表现及抗凝治疗效果而确立诊断。以肝素、潘生丁和低分子右旋扩酐三联或其中二联抗凝治疗。治愈25例，死亡3例。就如何达到早期诊断和治疗进行讨论，并介绍使用肝素的一些经验。

In this paper, we summarized the diagnostic and treating experience of 28 cases of neonatal disseminated intravas -cular coagulation(DIC). of 28 cases, 27 occured during 1 -6 days of life. The underlying disorders included infection, sclerema neonatrum, asphyxia neonatrum, et al. Clinical manifestation were mainly bleeding, microcideulation collapse, et al.The basic scueening tests included platelet count (BPC), prothrombin time (PT), and fibrinogen(FIB). if only 2 of the 3 screening tests positive, one or more abnmormality of the following tests should be added: coagulating time(CT), 3p test or fibrin degradation products (FDP), activated partial thromboplastin time (APTT), and more than 2% of schistocytes in smear. The role of thortening CT in the early diagnosis was emphasized. Besides te treatment of underlying disorders, the anticoagulation treatment included 2 of 3 of the following drugs: heparin, persentin, and dextrose. Of 28 cases, 25 wcre cured, 3 died. How to get the early diagnosis and treatment were discussed.