产科急性弥漫性血管内凝血12例临床分析

为探讨产科急性弥漫性血管内凝血(DIC)的临床表现及治疗措施，对珠江医院1993年1月-2001年7月收治的12例产科DIC患者进行回顾性分析。结果发现，12例均有不同的诱因，其中以羊水栓塞、妊高征为主。主要临床表现为出血、栓塞或循环障碍。全部病例均迅速得到确诊，及时给予去除病因、抗休克、补充凝血因子处理。12例中早期使用肝素9例，纤溶抑制剂8例，行子宫切除术5例。9例治愈，3例死亡。提示早期诊断、及时去除病因及抗休克处理、合理应用肝素及纤溶抑制剂是降低DIC死亡率的关键。

CLINICAL ANALYSIS OF 12 CASES OF DISSEMINATED INTRAVASCULAR COAGULATION IN OBSIETRICS

To investigate manifestations and treatment of acute disseminated intravascular coagulation (DIC) in obstetrics, the medical records of 12 cases of acute DIC in obstetric patients admitted into our hospital from January 1993 to July 2001 were analyzed retrospectively. The result showed that the major causes of DIC in obstetric patients were amniotic fluid embolism and pregnancy induced hypertension. The main manifestations were bleeding, embolism or impairment of circulation. In all of the 12 patients accurate diagnosis was made, and treatment including elimination of causes, anti shock measures and prompt complement of coagulation factors. Nine patients received heparin early, 8 received antifibrinolytic agents rationally, and in 5 patients hysterectomy was performed. Nine patients were cured, 3 died. The key to decrease mortality of DIC in obstetric patients is to diagnose DIC early, to eliminate the causes promptly, to treat shock actively, and to use heparin and antifibrinolytic agents more rationally.