Pulmonary embolus-induced disseminated intravascular coagulation

Pulmonary embolus as a cause of disseminated intravascular coagulation has only recently been recognized. The hemorrhagic disorder reported in the past was associated with little or no bleeding. We report a case of pulmonary embolus associated with life-threatening disseminated intravascular coagulation.     

Management of disseminated intravascular coagulation

Disseminated intravascular coagulation (DIC) is a complex condition in which diffuse clotting and profuse hemorrhaging occur simultaneously. It is a serious, often fatal, condition that is estimated to occur in approximately 10% of all patients diagnosed with cancer. No single laboratory test is available that is absolutely diagnostic for DIC; however, several laboratory results, combined with certain clinical findings, will support the diagnosis. Despite the lack of a standardized protocol for clinical management, aggressive medical and nursing care can play a prominent role in the clinical outcome of the patient with DIC.     

急性白血病与弥散性血管内凝血

目的分析急性白血病（AL）患者弥散性血管内凝血（DIC）的发生情况，凝血功能改变及其临床意义。方法对67例AL患者、25例AL完全缓解（CR）患者、20例健康体检者进行凝血常规、D-二聚体等检测。结果根据ISTH修订标准，15例AL患者合并DIC，发生率为22．4％，AML与ALL的DIC发生率AML-M3之间无统计学差异（P〉0．05），AML-M3与non-AML-M3的DIC的发生率之间有统计学差异（P〈0．05）。DIC组PT、APTT、TT较对照组、CR组及non-DIC组均明显延长（P〈0．01），而FIB则降低（P〈0．05）。结论AL尤其AML-M3患者容易合并DIC，观察患者凝血功能改变以及出血表现可有助于尽早发现DIC并指导临床预防及治疗，从而有利于改善AL合并DIC患者的临床预后。     

妊娠期高血压疾病与弥散性血管内凝血

妊娠期高血压疾病是妊娠期特有的疾病，也是产科常见的、严重威胁母儿安全的并发症。我国发病率为9．4％，国外报道为7％-12％。近年来的研究表明，妊娠期高血压疾病的发生与血管内皮细胞损伤及血管细胞因子的合成及障碍有关。其病理基础是全身小动脉痉挛，造成微小血管狭窄，血管壁渗透性增加。血液浓缩。此外，妊娠期高血压疾病患者的凝血因子活性多数增高，凝血功能亢进。上述病理生理变化，形成了妊娠期高血压疾病患者易发生弥散性血管内凝血（disseminated intravascular coagulation，DIC）的病理基础。     

弥散性血管内凝血诊断指南

<正>弥散性血管内凝血(disseminated intravascular coagulation,DIC)的诊断应包括临床和实验室资料(C级,水平Ⅳ)。国际血栓与止血委员会(ISTH)的DIC评分系统提供了客观的DIC诊断与治疗标准,该评分系统与临床和预后有关(C级,水平Ⅳ)。     

产科弥散性血管内凝血19例诊断分析

产科弥散性血管内凝血(DIC)病情凶险,进展迅速,直接威胁母婴生命,早期诊断是其治疗的关键。本研究旨在对我院7年来收治的19例产科DIC进行回顾分析,以探讨产科DIC的诊断及其相关问题。本研究中所有病例诊断均符合全国第六届血栓与止血会议制订的DIC诊断标准[1]。     

Coagulation inhibitors in sepsis and disseminated intravascular coagulation

Sepsis is a syndrome that is increasing in frequency and continues to be associated with an unacceptably high mortality. DIC is an important and common sequel of sepsis, is implicated in the development of multiple organ failure, and has been shown repeatedly to connote a poor prognosis. Increasing understanding of the pathogenesis of DIC has suggested several novel therapies designed to correct deficiencies in inhibitors of coagulation. To date, small randomized, controlled studies of antithrombin III concentrates in sepsis and DIC have shown a trend to increased survival, but have not achieved statistical significance. Currently, a large randomized controlled trial of antithrombin III in sepsis is being conducted. Until more data are available, important questions remain as to its proper place in the treatment of sepsis, septic shock, and DIC. Similarly, therapy with protein C and tissue factor-pathway inhibitor has been beneficial in animal models of sepsis and DIC. The results of controlled clinical trials in humans are eagerly awaited.