噬血细胞综合征并发DIC20例临床分析

目的:探讨噬血细胞综合征弥散性血管内凝血(DIC)的特点及治疗体会。方法:回顾性总结了20例在我院住院的噬血细胞综合征并发DIC的临床特点及治疗上的体会。结果:发现噬血细胞综合征起病急骤、病情变化快,几乎在确诊噬血细胞综合征的同时DIC即已存在,与其他疾病的DIC相比,更常见,更凶险,治疗更棘手,除大出血外,顽固性多脏器功能衰竭多见,尤以肝衰最常见。治疗上除了DIC的常规治疗外,激素和免疫治疗应早期应用。而免疫治疗的早期应用又取决于噬血细胞综合征的早期诊断。结论:噬血细胞综合征DIC的特点是:DIC出现早,顽固性多脏器衰竭中以肝衰最常见。治疗上积极针对DIC治疗,为噬血细胞综合征免疫救治赢得了时间。噬血细胞综合征早期诊断及早期进行免疫治疗是DIC根本好转的关键。

The clinical analysis of 20 cases of hemophagocytic syndrome complicated with DIC

Objective:To discuss the characteristics and treatment experience of hemophagocytic syndrome complicated with DIC.Method:The clinical characteristics and treatment experiences of 20 cases of hospitalized patients with hemophagocytic syndrome complicated with DIC were summarized retrospectively.Result:The onset of hemophagocytic syndrome was acute.The condition changes were rapid.DIC existed in nearly all the patients when the diagnosis of hemophagocytic syndrome was confirmed.Compared with other diseases complicated with DIC,DIC complicated with hemophagocytic syndrome was more common,dangerous and difficult to treat.In addition to hemorrhage,refractory multiple organ failure was common.Liver failure was the most common type.In addition to conventional treatment of DIC,the early application of hormone and immunotherapy were also very important.And the early application of immunotherapy depends on the early diagnosis of hemophagocytic syndrome.Conclusion:The characteristics of DIC complicated with hemophagocytic syndrome were:Early onset of DIC,Liver failure was the most common among refractory multiple organ failure.Positive treatment for DIC may gain time for the immunotherapy of hemophagocytic syndrome.The early diagnosis and the early immunotherapy of hemophagocytic syndrome were the key to the radical improvement of DIC.