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妊娠期弥散性血管内凝血:深入理解病因及管理可减轻产科医生的压力。

Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress.

作者信息

Lurie S, Feinstein M, Mamet Y

机构信息

Department of Obstetrics and Gynecology, Laniado Hospital, Netanya, Israel.

出版信息

Arch Gynecol Obstet. 2000 Feb;263(3):126-30. doi: 10.1007/s004040050010.

Abstract

In pregnancy and puerperium disseminated intravascular coagulopathy may accompany abruptio placenta, intrauterine fetal demise with retained dead fetus, amniotic fluid embolism, endotoxin sepsis, preecalampsia with HELLP and massive transfusion. Clinical signs and symptoms of DIC can include oozing from venipuncture sites and/or mucous membranes, red cell lysis from activation of the complement system, hemorrhage from coagulopathy and possible uterine atony, hypotension from hemorrhage and/or bradykinin release, and oliguria from end-organ insult and hypovolemia/hypotension. Treatment of DIC consists of replacement of volume, blood products, and coagulation components and cardiovascular and respiratory support with elimination of underlying triggering mechanism.

摘要

在妊娠和产褥期,弥散性血管内凝血可能伴有胎盘早剥、胎儿宫内死亡伴死胎滞留、羊水栓塞、内毒素败血症、伴有HELLP的先兆子痫以及大量输血。弥散性血管内凝血的临床体征和症状可包括静脉穿刺部位和/或黏膜渗血、补体系统激活导致的红细胞溶解、凝血病引起的出血以及可能出现的子宫收缩乏力、出血和/或缓激肽释放导致的低血压,以及终末器官损伤和血容量不足/低血压引起的少尿。弥散性血管内凝血的治疗包括补充血容量、血液制品和凝血成分,以及进行心血管和呼吸支持,并消除潜在的触发机制。

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