13例产科DIC的处理

目的 探讨产科DIC的临床诊治。方法 将13例DIC按年代、肝素剂量分成两组，第一组4例，1961—1983年，肝素总剂量125—150mg；第二组9例，1984—2001年，肝素总剂量12．5—75mg，比较两组母儿预后。结果 第一组全子宫切除3例，以输库血为主，存活3例，死亡1例；第二组全子宫切除3例，补充凝血因子、恢复和维持血容量，全部存活。结论 抢救成功的关键为识别DIC早期症状，小剂量肝素的选择性应用，恢复和补充血容量，充分供氧，必要时行全子宫切除术。

Approaches to 13 Cases of Obstetric Disseminated Intravascular Coagulopathy

Objective To explore clinical approaches to the management of obstetric disseminated intravascular coagulopathy ( DIG). Methods Thirteen DIC patients were divided into two groups according to the year of illness and heparin dosage. Group 1, 4 from 1961-1983, 125-150mg dosage of heparin was given in 4 patients. Group 2, included 5 patients with amniotic fluid embolism and 4 patients with placental abruption receiving 12. 5-75mg of heparin from 1984-2001. Results In group 1, 3 patients underwent total hysterectomy with banked blood infusion. Three patients survived and one patient died. In group 2, 3 patients had total hysterectomy. Maintainence of blood volume and replacement of blood loss together with essential coagulation factors dominated the operative regime. All patients survived. Conclusion The critical treatment of obstetric DIC consists of: identification of the precursory signs, selective use of small dosage heparin, replacement of volume together with blood products and coagulation components as well as respiratory support and total hysterectomy if necessary.