凝血与纤溶监测在围术期产妇弥散性血管内凝血的诊断价值

Diagnosis Value of Blood Coagulation and Fibrinolysis test in Disseminated Intravascular Coagulation with Perioperative Maternal

目的分析凝血与纤溶系统水平在围术期产妇弥散性血管内凝血(DIC)的诊断价值。方法从2013年4月到2014年1月,选取我院的52例围术期产妇进行回顾性分析,作为观察组,选取同期在我院体检正常的健康孕妇44例作为对照组,对比两组凝血与纤溶指标,进行分析。结果不同病因产妇发生DIC的产前状态的凝血与纤溶系统检查结果不同,表明在发生DIC的产妇在产前状态时,常规检查就有各种凝血时间延长,纤维蛋白原(Fbg)降低,D二聚体(D-D)升高;不同病因产妇发生DIC时的凝血与纤溶系统检查结果不同,表明随着产妇DIC的发生各种凝血时间延长,Fbg降低,D-D升高;与对照组产妇比较,观察组的PLT计数和Fbg水平显著性降低,而PT、TT及aPTT显著性增加,D-D升高,两组比较差异具有统计学意义(P<0.05)。结论凝血与纤溶系统水平对于围术期产妇DIC具有重要的诊断意义,aTPP、PT和TT水平的升高提示患者凝血功能下降,而的升高则说明纤溶的发生。

Objective To study blood coagulation and fibrinolysis system level in perioperative mater- nal diagnosis of disseminated intravascular coagulation （ DIC ） value. Methods From April 2013 to January 2014, selected 52 cases of perioperative women in our hospital, and they were retrospectively analyzed, and as a group, selected the same period in our hospital check-up 44 cases of normal healthy pregnant women as con- trol group, compared two groups of blood coagulation and fibrinolytic indexes, testing and analysis. Results The different causes of DIC prenatal maternal status of blood coagulation and fibrinolysis system test results, show that in the case of DIC in prenatal maternal status, routine inspection will have all kinds of blood coagu- lation time extended,Fbg decreased,D-D increases;Different cause of maternal DIC of blood coagulation and fibrinolysis system test results, showed that as the maternal DIC occur all kinds of blood coagulation time ex- tended, Fbg decreased, D-D increases further;Compared with control group in maternal, observation group PLT count and Fbg levels significantly lower, and PT ,TT and aPTT significantly increased, D-D increases, the more similar between the two groups have statistical significance （ P 〈 0. 05 ）. Conclusion The blood coagulation and fibrinolysis system level for perioperative DIC diagnostic significance, maternal aPTT, PT and TT higher levels of blood coagulation function in patients with prompt to drop, while the rise of fibrinolytic occurs, is worth further promotion in the clinical practice.