以内脏出血为首发表现的获得性凝血障碍30例临床分析

目的分析以内脏出血为首发表现的获得性凝血障碍的病因及临床特点，探讨获得性凝血障碍的诊治方案。方法对30例以内脏出血为首发表现的获得性凝血障碍患者的病因、临床表现、实验室检查及治疗转归进行分析。结果10例起病前有上呼吸道感染及／或服药史；8病例有自服或误服灭鼠药史；9例原因不明。首发表现主要有肉眼血尿、阴道出血等，大部分病例先后或同时伴有多部位出血。实验室检查：血小板计数正常或偏高，血小板聚集率正常。aPTT、PT均延长。经应用维生素K1、凝血酶原复合物、新鲜冰冻血浆、冷沉淀等治疗，所有病例病情好转，实验室指标恢复正常。结论临床上无原发疾病的获得性凝血功能障碍病例并不少见，应强调血常规、出凝血检查的重要性。确定为凝血功能障碍后需进一步明确病因，对原因不明者应进一步检查并动态追踪观察。

To Analyze 30 Cases of Acquired Coagulopathy With Edible Viscere Hemorrhage Initially

Objective To analyze the etiopathogenisises and clinical feature of acquired coagulopathy with edible viscera hemorrhage initially, as well as to approach the diagnosis and treatment feature of these desease. Methods Analysis was made on etiopathogenisises, clinical manifestation, laboratory examination, and healing turnover of 30 cases with edible viscera hemorrhage. Results 10 cases have upper respiratory infection and/or drug history; 8 cases have already taken voluntarily and wrongly deratization drug; 9 cases were unknown aetiology. Initial symptom mainly consist of gross hematuria and colporrhagia with sequential or simultaneous multiple regions haemorrhage. Laboratory examination showed that platelet count were normal or slightly high , platelet aggregation rate were normal, aPTT and PT were both extend. By the treatment of Vita-min K1, thrombin, fresh frozen plasma, all cases pathogenetic condition improve and lab indexes recover. Conclusion Clinically, acquired coagulopathy is not uncommon. Meanwhile blood routine, hemorrhage test and blood clotting check should be thought highly. If coagulopathy is definited, further research cause is essential. If not, more checks and dynamic tracing observations should be done.