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目的探讨产科弥漫性血管内凝血(DIC)的发病原因、临床表现、诊断和治疗。方法回顾性分析1989年1月~2012年本院共收治10例产科DIC患者。结果 10例患者诊断均正确,在抗休克,大量输血及应用凝血因子的基础上,5例患者使用了肝素,6例患者行子宫次全切除术,同时行双侧髂内动脉结扎术2例。10例患者抢救成功8例,死亡2例。结论该病的主要发病机制是在某些致病因子作用下凝血因子或血小板被激活,大量可溶性促凝物质进入血液循环,从而引起凝血功能异常。早期诊断,及时去除病因,把握时机正确治疗是抢救DIC成功的关键。
Objective To investigate the causes, clinical manifestations, diagnosis and treatment of obstructive intravascular coagulation (DIC) in obstetrics. Methods A retrospective analysis from January 1989 to 2012, our hospital received a total of 10 obstetric patients with DIC. Results All the 10 patients were diagnosed correctly. Five patients were treated with heparin on the basis of anti-shock, massive blood transfusions and coagulation factors. Six patients underwent subtotal hysterectomy and bilateral iliac artery ligation . 10 patients were successfully treated in 8 cases, 2 died. Conclusion The main pathogenesis of this disease is the activation of coagulation factors or platelets under the action of certain virulence factors. A large number of soluble procoagulant substances enter the blood circulation, causing coagulation disorders. Early diagnosis, timely removal of the cause, to seize the right opportunity is the key to successful DIC rescue.