弥漫性血管内凝血100例临床诊治体会

Clinical treatment analysis of 100 cases of disseminated intravascular coagulation

[目的]早期及时的诊断及正确的治疗弥漫性血管内凝血(DIC),以减少误诊及死亡率,提高治愈率。[方法]回顾性统计大连医科大学第二临床学院近3年来各科疾病合并DIC100例的一般状况及其基础疾病、诊断和治疗、转归情况。[结果]内科系统疾病DIC发生率最高,占82%,其中以血液系统疾病,尤其是M3型白血病最易合并DIC,占22%;其次为实体瘤,占7%;再次为外科系统疾病,占6%;最后是神经系统疾病和妇科病,分别占4%和1%。常规治疗效果总治愈率为67%,死亡率为33.0%,脑出血是其主要死因。[结论]DIC的诊断除了目前应用的标准外,还要结合凝血因子和血液凝固调节蛋白的活性测定及血栓止血标志物来诊断。DIC一经确诊就要尽早治疗,早期治疗可以明显降低死亡率,提高治愈率。治疗关键是祛除原发病,肝素化治疗。晚期以纤溶为主、有严重出血倾向,方可抗纤溶治疗。

[Objective] Disseminated intravaseular coagulation （DIC） was a symptom - complex of thrombus and hemorrhage. We investigate the clinical features, diagnosis and management of 100 cases of DIC patients to diagnose the disease early and treat it in time and accurately ,and then to drop the mortality rates markedly. [ Method] Clinical data of 100 cases of acute DIC was retrospectively analyzed. [ Results] All kinds of disease can take plase DIC, but internal medicine disease is more than other diseases, the incidence rate was 82.0% ,and hematological system disease （M3 leukemia） is the most, the incidence rate was 22.0%. We use the conventional therapy,and the effective rate was 67.0%. [Conclution] The diagnosis of DIC have other standard such as the mensuration of thrombokinesis regulatory protein and other thrombo - rrhage markers except for our current standard. The most important therapy is to eliminate the inducement, use heparin preventively, and use the anti- fibrinolytis drugs if patients had being in advanced stage （Fibrinolytis is primary. ）