产科弥散性血管内凝血的诊断与治疗

Diagnosis and Treatment of Disseminated Intravacular Coagulation in Obstetrics

目的 探讨产科弥散性血管内凝血(DIC)的早期诊断与有效治疗方法。方法 对23例产科患者按照DIC诊断标准确诊为DIC,分别采取不同的治疗方法:①治疗产科原发疾病,去除诱因;②高凝期及时用肝素抗凝剂,25 -50 mg/次,间隙给药,24 h总量50-200mg;③消耗性低凝期主要采用血浆、血小板输入代替治疗,适当应用小剂量肝素;④继发纤溶期仅在DIC晚期使用抗纤溶药物。结果 完全治愈19例(83%),死亡4例(17%),均系羊水栓塞死于脏器功能衰竭者。结论 对于产科DIC患者,做到早期诊断,去除诱因,及时恰当应用肝素抗凝剂,加强支持治疗,防治脏器衰竭,是抢救产科DIC患者成功的关键。

Objective To investigate early diagnosis and effective treatment of obstetrics disseminated intravascular coagulation DIC. Methods 23 patients were diagnosed DIC that according to criterion of DIC and were treated in different methods. These methods included treating obstetric primary disease, removing cause of disease; using heparin; infusing plasma and platelet concentrate, and using antifibrinolytic agents. Results 19 patients have recovered ,4 patients died of multiple organs failure due to thrombosis of aminotil fluid. Conclusion Early diagnosis removing cause of disease,using heparin,and preventing organs failure are key measures for treating patients of obstetric DIC.