125例妊娠并发弥散性血管内凝血原发病因与预后分析

Primary Diseases and Prognostic Analysis of 125 Pregnancy Complicated with Disseminated Intravascular Coagulation

目的:探讨妊娠并发弥散性血管内凝血(DIC)患者的原发病因及其预后。方法:对2004年1月至2009年12月我院收治的125例妊娠并发DIC患者的病因及其死亡原因进行回顾性分析。结果:①125例妊娠并发DIC患者主要病因为产后出血49例(39.2%)、胎盘早剥25例(20.0%)、妊娠期急性肝病15例(12.0%)、重度子痫前期或子痫10例(8.0%)、羊水栓塞10例(8.0%)。②26例死亡患者引起死亡的主要病因为羊水栓塞(50.0%,5/10)、妊娠期急性肝病(40.0%,6/15),产后出血(16.3%,8/49),胎盘早剥(16.0%,4/25)。③不同病因的DIC死亡患者出现功能障碍的器官不一样。结论:妊娠并发DIC原发病因中以产科因素为主;不同原发病因DIC患者死亡率有明显差异,累及的系统或器官不同。提示临床工作中可根据不同原发病因采取相应的预防和治疗措施。

Objective：To analyze the primary diseases and prognosis of 125 pregnancy complicated with disseminated intravascular coagulation（DIC）.Methods：A retrospective study was conducted from January 2004 to December 2009 in the third affiliated hospital of guangzhou medical college,primary disease and prognosis of 125 pregnancy with DIC were evaluated.Results：①The main primary causes were postpartum hemorrhage（49 cases,39.2%）,placenta abruption（25 cases,20.0%）,pregnancy with acute liver disease（15 case,12.0%）,severe preeclampsia or eclampsia（10 cases,8.0%）,amniotic fluid embolism（10 case,8.0%）.②The causes of death in 26 cases were amniotic fluid embolism（50.0%,5/10）,pregnancy with acute liver disease（40.0%,6/15）,postpartum hemorrhage（16.3%,8/49）,placenta abruption（16.0%,4/25）.③Patients died of DIC with different primary disease had different organ dysfunction.Conclusions：Primary diseases leading to DIC in pregnancy are mainly due to obstetric factors.mortality of Patients with DIC is different according to different primary diseases,and the failured organs are different.So the preventive and therapeutic measures should be taken according to different primary diseases.