重症胆道感染围手术期合并弥散性血管内凝血的诊断和治疗

Diagnosis and treatment of severe perioperative infection complicated with DIC

目的探讨围手术期重症胆道感染合并DIC的早期诊断和综合治疗的效果。方法对21例重症胆道感染合并DIC的病人进行综合性治疗．监测治疗前后病人的凝血功能。结果21例病人中，治愈19例，死亡2例，治愈率90．5％。治疗前与治疗后相比，出血倾向得到控制，腹腔出血停止，病人的凝血酶原时间（PT）明显缩短．纤维蛋白原（Fbg）含量增加，D-二聚体及FDPs水平明显下降。结论围手术期重症胆道感染病人易合并DIC，且病死率高，早期明确诊断并进行有效的综合性治疗是关键，尤其是冷沉淀联合低分子肝素的应用。

Objective To discuss the early diagnosis of severe perioperative biliary infection complicated with DIC and efficacy of comprehensive treatment for it. Methods Comprehensive treat ment was conducted in 21 patients who had intensive biliary infection complicated with DIC. The hemoglutination function was monitored before and after treatment. Results Of the 21 palients, 19 were cured and 2 dead. The curative rated was 90.5%. The hemorrhage tendency was controlled, abdominal bleeding stopped, prothrombin time （PT） obviously reduced, content of fibrinogen（Fbg）in creased, level of l〉dimer and FDPs obviously dropped. Conclusion The patients who have biliary infection in the perioperative period are easy to suffer from DIC and the mortality is high. Early diagno- sis and comprehensive therapy, especially the application of the cryofibrinogen and heparin, are very important.