恶性肿瘤合并弥散性血管内凝血临床分析

Clinical Analysis Cases of Disseminated Intravascula Coagulation with Malignant Tumor

目的探讨恶性肿瘤合并弥散性血管内凝血(disseminated intravascular coagulation,DIC)的临床特点及诊治。方法对26例恶性肿瘤合并DIC患者的临床资料进行分析。结果血小板减少18例,纤维蛋白原<1.5 g/L22例,D-二聚体阳性24例。26例患者中治愈10例,显效6例,总有效率61.5%,自动出院3例,死亡7例。结论颅内出血是影响恶性肿瘤合并DIC预后的不利因素;恶性肿瘤诱发的DIC在疾病初发期;早期肝素抗凝治疗,积极治疗原发疾病,是DIC抢救成功的关键。

Objective To explore the clinical characteristics and the experiences of diagnosis and treatment of disseminated intravascular coagulation （DIC） with malignant tumor. Methods Clinical and laboratory data of 26 cases of DIC with malignant tumor were retrospectively analyzed. Results Hemorrhage was one of the most common clinical manifestations of DIC with malignant tumor. The decrease in the number of platelet and concentration of fibrinogen and the increase in the concentration of fibrinogen/fibrin degradation products（FDP） and D- dimer（ D- D） were the main unwonted labo- ratory investigations. Ten cases were cured and 6 cases presented response in 26 cases, its efficiency was 61.5%. Conclusion The cerebral hemorrhage is the disadvantageous factor that influenced prog- nosis of DIC with malignant tumor. The DIC induced by malignant tumor occurred easily in the first diagnostic stage. The heparin therapy in the early stage and the treatment of pathogen are the pivotal fac- tors that treated DIC successfully.