产科弥散性血管内凝血18例诊治分析

Treatment of disseminated intravascular coagulation in Obstetrics Deaprtment

目的:探讨产科弥散性血管内凝血(DIC)的病因、诊治及预防措施。方法:回顾性分析我院1998年1月～2010年8月发生的18例产科DIC患者的临床资料。结果:诱发产科DIC的病因主要有:羊水栓塞、胎盘早剥、HELLP综合征、子痫和先兆子痫、妊娠合并重症肝炎、产后出血、子宫破裂、产科重症感染、过期流产、死胎。18例患者中,抢救成功15例,成功率83.3%。剖宫产9例,子宫切除4例。结论:早期诊断,快速去除病因,及时终止妊娠或切除子宫,大量补充凝血因子,合理使用小剂量肝素是抢救产科DIC成功的关键,可降低死亡率。

Objective： To explore the etiology,diagnosis and treatment for intravascular coagulation（DIC） in Obstetrics Deaprtment.Methods： Clinical data of 18 cases with DIC in Obstetrics Deaprtment admitted from Jan 1998 to Aug 2010 were analyzed retrospectively.Results： Main etiology of DIC in in Obstetrics Deaprtment included amniotic fluid embolism,placental abruption,HELLP syndrome,eclampsia,preeclampsia,pregnancy complicated by serious hepatitis,postpartum hemorrhage,metrorrhexis,severe infection,missed abortion and fetal death.A total of 15 cases were rescued（88.8%）,9 cases had cesearean section and 4 cases had hysterectomia.Conclusions： Early diagnosis,rapid removal of etiology,termination of pregnancy or hysterectomy in time,supplement of blood coagulation factor,and reasonable usage of low-dose heparin are important in resuing DIC and can lower the mortality.