妊娠并发DIC15例临床研究.docVIP

妊娠并发DIC15例临床研究[摘要] 目的：探讨妊娠并发弥漫性血管内凝血（DIC）对母婴结局的影响。方法：回顾性分析2001年1月～2011年4月本院10年间妊娠并发DIC 15例孕产妇的临床资料。结果：DIC的诱发因素有产后出血6例，胎盘早剥5例，子痫3例，羊水栓塞1例；母婴结局为孕产妇死亡0例，围产儿死亡4例，产妇急性肾功能衰竭1例，剖宫产12例，子宫切除5例。结论：妊娠并发DIC与胎盘早剥、产后出血关系密切，在积极治疗同时应防治产妇并发症尤其是肾功能的保护和监测。 [关键词] 妊娠；弥漫性血管内凝血；母婴结局；胎盘早剥；产后出血 [中图分类号] R714 [文献标识码] B [文章编号] 1674-4721（2012）01（a）-171-02 Clinical analysis of 15 cases of acute disseminated intravascular coagulation in pregnancy LI Ling, SONG Zihui Department of Gynecology and Obstetrics, Aerospace Central Hospital, Beijing 100039, China [Abstract] Objective: To investigate the influence of acute disseminated intravascular coagulation(DIC)in pregnancy on the outcome of mother and infant. Methods: To analyze the clinical data of 15 cases with DIC in pregnancy from January 2001 to April 2011 retrospectively. Results: The predisposing factor of DIC were postpartum hemorrhage in 6 cases, placental abruptions in 5 cases，eclampsia in 3 cases, amniotic fluid embolism in 1 case. There was no maternal death, 4 cases of neonates died, acute renal failure in 1 cases, 12 cases of cesarean section was performed, 5 cases of hysterectomy was performed. Conclusion: Acute disseminated intravascular coagulation in pregnancy is correlated with placental abruptions and postpartum hemorrhage. We should treat it actively and at the same time prevent pregnancy complications in special of the protection and observation of renal function. [Key words] Pregnancy; DIC; Pregnancy outcome; Placental abruption; Postpartum hemorrhage 孕产妇弥漫性血管内凝血（DIC）是一种严重的产科并发症。DIC是以凝血功能障碍为主要特征，出血且不凝为主要表现的综合征，严重时危及母婴的健康甚至生命，有的造成终生的器官损害。现就本院15例发生DIC孕产妇的临床资料进行分析如下： 1 资料与方法 1.1 一般资料 选择2001年1月～2011年4月本院10年间住院发生DIC的孕产妇15例，DIC诊断参照疾病诊断标准[1]。年龄20～38岁，平均（28.2 ±1.2）岁， 孕周20～43周， 平均（36.0±5.4）周，初产妇9例，经产妇6例；发生DIC的时间：2例在住院前，13例在住院后。4例发生在分娩前，11例发生在胎儿娩出后。 1.2 临床表现 出血15例，以阴道、宫腔大出血为主要表现。14例均有大出血，出血量1 500～12 000 ml。1例伤口及针眼渗血。肉眼血尿12例。一经诊断DIC立即治疗原发病、抗休克、扩容、输新鲜血、新鲜冰冻血浆、纤维蛋白原，必要时切除子宫。 2 结果 发生DIC的15例产妇原发疾病为