Kurihara I, Yamaguchi Y, Soma J, Sato H, Ito S, Saito T
Department of Internal Medicine, Miyagino Hospital, Sendai Red Cross Hospital, Japan.
Nihon Jinzo Gakkai Shi. 2000 Oct;42(7):603-7.
We describe here two cases of chronic disseminated intravascular coagulation(DIC) secondary to aortic aneurysms. The patients were 78- and 84-year-old males, who visited our hospital to receive hemodialysis therapy for chronic renal failure probably due to nephrosclerosis. They had mild bleeding tendency and thrombocytopenia(< 10 x 10(4)/microliter). Coagulation test revealed the findings of chronic DIC in both patients, and computed tomography showed abdominal and thoracoabdominal aortic aneurysms with mural thrombi, respectively. In one patient, subcutaneous hemorrhage after vascular access surgery had continued for a month. However, the hemorrhage and swelling of the limb disappeared after continuous subcutaneous heparin infusion(CSHI) therapy in a daily dose of 10,000-14,000 unit. These findings suggest that chronic DIC secondary to aortic aneurysm should be considered when bleeding tendency and thrombocytopenia are observed in aged patients, and that CSHI is the choice of therapy for the bleeding tendency of chronic DIC.
我们在此描述两例继发于主动脉瘤的慢性弥散性血管内凝血（DIC）病例。患者为78岁和84岁男性，因可能因肾硬化导致的慢性肾衰竭来我院接受血液透析治疗。他们有轻度出血倾向和血小板减少症（<10×10⁴/微升）。凝血检查显示两名患者均有慢性DIC表现，计算机断层扫描分别显示腹主动脉瘤和胸腹主动脉瘤伴附壁血栓。其中一名患者血管通路手术后皮下出血持续了一个月。然而，每日剂量为10000 - 14000单位的皮下持续肝素输注（CSHI）治疗后，肢体的出血和肿胀消失。这些发现表明，老年患者出现出血倾向和血小板减少症时应考虑继发于主动脉瘤的慢性DIC，且CSHI是治疗慢性DIC出血倾向的首选疗法。
