8例产科DIC患者临床表现及诱因分析

Clinical manifestations for DIC and causative results in 8 cases

目的：分析产科DIC的临床表现及诱因。方法：回顾性分析我院2004年1月～2012年12月间发生的8例产科典型DIC病例的临床资料。结果：①产科DIC主要表现为阴道大出血和休克，多为急性，且病情发展迅猛，不易用原发病解释微循环衰竭或休克，早期发现且及时治疗，预后较好。②诱因明确，如死胎、胎盘早剥、羊水栓塞、产后出血、药物过敏、双胎、肝损、妊娠高血压、HELLP综合征、生殖器感染等；8例孕产妇中死亡1例，子宫切除5例，发生严重后遗症1例，死产3例，死胎2例。结论：由于妊娠后血液、循环系统的特殊变化，孕产妇DIC发生几率升高，应高度重视有发生产科DIC诱因的病例；一旦发生DIC，积极果断地处理是成功救治的关键。

Objective：To investigate the clinical pictures of disseminated intravascular coagulation （ DIC） and its causative results.Methods：The clinical manifestations of DIC and its causative results were retrospectively examined in 8 patients undergone treatment in our hospital between January 2004 and December 2012.Results：Obstetric DIC was primarily characterized by heavy vaginal bleeding and shock.The disease developed acutely and quickly,and refused to diagnose on primary causes basis regarding the microcirculatory failure and shock .Early confirmation and timely intervention had led to better prognosis.Nevertheless,causative results were commonly associated with stillbirth,premature placental abruption,amniotic fluid embolism,postpartum hemorrhage,drug allergy,twin labor,liver damage,pregnancy-induced hypertension,HELLP syndrome and genital infections.In 8 patients,one death oc-curred,5 underwent hysterectomy,and 1 was suffered from severe sequela.Stillbirth occurred in 3,and dead fetus in 2.Conclusion：Pregnancy related DIC is in higher incidence due to specific changes of maternal blood and circulatory system ,and cases with higher risk factors require special attention .Aggres-sive and decisive management can lead to successful outcomes for DIC upon its attack .