产科弥漫性血管内凝血的临床诊治分析

Clinical Analysis of Diagnosis and Treatment of Obstetric Disseminated Intravascular Coagulation

目的:探讨产科弥漫性血管内凝血(DIC)的发病原因、临床诊断及治疗措施。方法:回顾性分析本院21例产科DIC患者的临床资料。结果:产科DIC的发病原因依次为重度胎盘早剥者(8例,38.1%)、子痫和先兆子痫(4例,19.0%)、羊水栓塞(3例,14.3%)、产后出血(2例,9.5%)、前置胎盘(1例,4.8%)、死胎(1例,4.8%)、子宫破裂(1例,4.8%)、妊娠合并重症肝炎(1例,4.8%)。21例患者中,抢救成功18例,成功率85.7%,行子宫切除术6例。结论:早期诊断DIC,尽快清除致病因素,及时终止妊娠或切除子宫,大量补充凝血因子和合理使用肝素均为产科DIC的有效治疗措施。

Objective：To investigate the pathogenesis,clinical diagnosis and the treatment measures of obstetrics disseminated intravascular coagulation（DIC）.Methods：The clinical data of 21 obstetric patients with DIC were retrospective analyzed.Results：The incidence causes of obstetric DIC were severe placental abruption（8 cases,38.1%）,preeclampsia and eclampsia（4 cases,19.0%）,amniotic fluid embolism（3 cases,14.3%）,postpartum hemorrhage（2 cases,9.5%）,placenta previa（1 cases,4.8%）,uterine rupture（1 cases,4.8%）,stillbirth（1 cases,4.8%）,pregnancy complicated with severe hepatitis（1 cases,4.8%）.In 21 patients,18 cases were rescued successfully,the success rate was 85.7%,6 cases underwent hysterectomy.Conclusion：The effective treatment of obstetric DIC were the early diagnosis of DIC,as soon as possible to remove pathogenic factors,timely termination of pregnancy or removal of the uterus,supplement of blood coagulation factor and rational use of heparin.