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目的 :探讨肝素治疗弥散性血管内凝血 (DIC)致顽固性休克的价值。方法 :收集DIC致顽固性休克应用肝素治疗患者的临床资料 ,分析肝素治疗时机、用量与休克、出血倾向、实验室指标、直接死亡原因等之间关系。结果 :11例患者 ,年龄 6 0 .0± 11.6岁 ;所有患者均合并有顽固性休克 ,普通肝素持续静脉滴注 ( 1～ 5mg/h)后缓解 10例 ( 90 .9% ) ;8例治疗前有出血倾向患者 ,治疗后明显好转 7例 ( 87.5 % ) ;所有患者中痊愈出院 3例 ( 2 7.3% ) ,仅 1例直接死亡原因与DIC有关。结论 :小剂量普通肝素 ( 1～ 5mg/h)持续静脉滴注试验性治疗有效 ,不但是DIC致顽固性休克综合救治的主要措施 ,也是DIC早期诊断的重要依据。
Objective: To investigate the value of heparin in the treatment of intractable shock caused by disseminated intravascular coagulation (DIC). Methods: The clinical data of patients with refractory shock caused by DIC were collected, and the relationship between the timing and dosage of heparin therapy, shock, bleeding tendency, laboratory indexes and direct causes of death were analyzed. Results: Eleven patients, age 60.0 ± 11.6 years, all patients with refractory shock, 10 cases (90.9%) were treated with continuous heparin infusion (1 ~ 5mg / h) There were 7 patients (87.5%) who had hemorrhage predisposition before treatment, and 3 patients (2 7.3%) were discharged after treatment. Only 1 patient died of DIC. CONCLUSION: Continuous intravenous infusion of low-dose unfractionated heparin (1-5 mg / h) is an effective experimental treatment, which is not only the primary measure for the comprehensive treatment of intractable shock caused by DIC, but also an important basis for the early diagnosis of DIC.