重症水痘合并弥散性血管内凝血的临床分析

Clinical analysis of severe varicella complicated with disseminated intravascular coagulation

目的总结分析重症水痘合并弥散性血管内凝血(DIC)的临床特点、治疗及预后。方法对本院2014—2018年收治的12例重症水痘合并DIC病例的临床资料进行回顾性分析。结果6例有基础疾病,临床表现以发热、皮疹密集、出血、颜面及四肢浮肿、腹痛为主,9例血小板<100×10^9/L,12例均有凝血功能异常,7例皮疹分泌物细菌培养阳性,5例为金黄色葡萄球菌,其中2例为耐甲氧西林金黄色葡萄球菌,10例存在≥2个脏器损害。6例痊愈,5例死亡,1例放弃。结论免疫功能低下者易出现重症水痘;重症水痘合并DIC临床表现多样,病情重,进展快,病死率高;早期识别,积极治疗,可以改善预后。

Objective To summarize and analyze the clinical characteristics,treatment and prognosis of severe varicella complicated with disseminated intravascular coagulation(DIC).Methods A retrospective analysis was made on the clinical data of 12 cases of severe varicella complicated with DIC enrolled in our hospital from 2014 to 2018.Results Six cases had basic diseases,and the main clinical manifestations were fever,denses rash,bleeding,face and limb edema,abdominal pain,9 cases had platelet<100×10^9/L,12 cases had abnormal coagulation function,7 cases had positive bacterial culture of rash secretion,5 cases were Staphylococcus aureus,and 2 cases of which were methicillin-resistant Staphylococcus aureus,10 cases had more than 2 organ damage.Six cases recovered,5 cases died and 1 case abandoned.Conclusion Severe varicella is easy to occur in patients with low immune function;severe varicella complicated with DIC has various clinical manifestations,severe disease,rapid progress and high mortality,early identification and active treatment can improve the prognosis.