Sonoclot 凝血分析用于DIC的治疗

目的采用Sonoclot凝血分析技术,对术中DIC病人进行分析和诊断。方法针对凝血功能障碍的不同阶段采用不同的治疗方法,对处于高凝期的患者,立即静脉推注肝素,并持续监测患者的凝血功能,根据纤维蛋白凝结速率决定是否需要补充凝血因子。对于消耗低凝期患者,输入红细胞、新鲜冰冻血浆、冷沉淀及纤维蛋白原、凝血酶原复合物等改善凝血功能,维持血容量,血小板功能降低的则输入血小板,并持续监测,一直到Sonclot值恢复正常,其他各项DIC检查指标恢复正常,这一期肝素的用量应少。结果15例病人中,1例严重复合外伤病人因大面积渗血经抢救无效死亡,另1例肠梗阻病人术中即发生全身多处血栓栓塞,术后3h死亡,其余13例3～6h凝血功能明显改善,24h后基本恢复正常。结论Sonoclot可以进行床边快速检测,几分钟即出结果,它的SonACT、纤维蛋白凝结速率、血小板功能等指标与DIC各期的实验室检测有良好的相关性,且可了解凝血的全过程。因此,Sonoclot凝血分析对及早和正确的诊断、处理DIC有重大价值。

The Application of Sonoclot Coagulation Analysis to DIC

Objective To analyze and diagnose the patients of disseminated intravascular coagulation (DIC) by the technique of Sonoclot's coagulation analysis. Methods At different stages, different therapies were applied to the DIC patients who were continually monitored till Sonoclot values and the other parameters recovered to normal. Results Of the 15 patients, 13 ones' coagulation functions improved clearly in 3~6 hours and reached normal in 24 hours, except one who suffered from severe compound trauma and failed to be rescued because of large bleeding, and one who suffered from intestinal obstruction and died from multiple thrombo-embolism during the operation. Conclusion Sonoclot, whose findings can be reported in minutes, can be applied to DIC as a rapid test. Its parameters such as SonACT, fibrin coagulating speed and platelet function not only are correlative to those of the laboratory test at various DIC stages, but also reflect the whole course of coagulation. So Sonoclot coagulation analysis is valuable to the early diagnosis and therapy of DIC.