产科弥漫性血管内凝血63例临床分析

Clinical analysis of 63 cases of disseminated intravascular coagulation in obstetrics

目的探讨产科DIC的发病原因、预防及正确处理方法。方法对2001年1月-2010年12月诊治的63例产科DIC进行回顾性分析。结果产科DIC的发病原因依次为重度胎盘早剥、子痫及重度子痫前期、羊水栓塞、产后大出血、前置胎盘、死胎、子宫破裂、妊娠合并肝病等。治愈率76.19%,死亡率23.81%。行子宫切除术21例,子宫切除率33.33%。结论及时处理DIC的诱发因素,预防DIC的发生,一旦发生DIC,在积极治疗原发病的同时,中心静脉压监测、成分输血、补充大量的凝血因子、小剂量肝素的应用、及时果断地切除子宫是抢救产科DIC成功的有效方法。

[ Objective ] To study the predisposing factors, pretention and the right method of therapy when DIC happened in obstetric. [Methods] 63 cases of obstetric DIC were analyzed retrospectively during January 2001 to December 2010. [Results] The predisposing factor of obstetric DIC was that severe placental abruption, eclampsia and severe pre-eclampsia, amniotic fluid embolism, postpartum hemorrhage, placenta previa, fetal death, rupture of uterus, liver disease of pregnancy and so on. Cure rate： 76.19%, mortality rate 23.81%. Hysterectomy was performed on 21 cases （33.33%）. [Conclusionsl We should deal with the incentives of DIC immediately, and prevent DIC oc- currence. Once it occurs, the successful emergency treatment of obstetric DIC includes following： component trans- fusion, supplement large amount of blood clotting factor, small dosage heparinls use, cut hysterectomy in time and resolutely, meanwhile treating with primary disease positively.