Welch R D, Watkins J P, Taylor T S, Cohen N D, Carter G K
College of Veterinary Medicine, Department of Large Animal Medicine and Surgery, Texas A&M University, College Station.
J Vet Intern Med. 1992 Jan-Feb;6(1):29-35. doi: 10.1111/j.1939-1676.1992.tb00982.x.
Disseminated intravascular coagulation (DIC) secondary to colic was diagnosed in 23 horses. Each horse was categorized retrospectively as to the cause of the colic based on surgical and/or necropsy findings: group 1 consisted of 14 horses with compromised intestine that required resection and anastomosis; group 2 consisted of 3 horses with nonstrangulating intestinal displacement and/or impactions; and group 3 consisted of 6 horses with colic associated with enteritis and/or colitis. Horses were considered to be affected with DIC if at least three of five hemostatic parameters were significantly abnormal: decreased antithrombin III (AT III) values, increased level of fibrin degradation products (FDP), thrombocytopenia, prolonged activated partial thromboplastin time, and prolonged prothrombin time. The most consistent hemostatic abnormalities were decreased AT III activity, increased FDP titers, and thrombocytopenia. Clotting times were more variable and did not always correlate with the presence of excessive hemorrhage. Excessive hemorrhage was present during surgery in seven horses and occurred within 1 to 12 hours after surgery in nine other horses. In addition to treatment of the primary disease, 19 horses received treatment for DIC consisting of heparin and/or plasma or fresh whole blood transfusions. Heparin alone was used in 12 horses. Heparin, in addition to fresh whole blood transfusions or fresh plasma, was administered to four horses. Three horses were treated with plasma alone. Four other horses were not treated specifically for the DIC. Eight horses (34%) survived the acute coagulopathy. Although a greater proportion of the surviving horses received heparin therapy (87.5%; 7/8) than did those that died (60%; 9/15), the difference was not statistically significant (P = 0.345).(ABSTRACT TRUNCATED AT 250 WORDS)
23匹马被诊断为继发于绞痛的弥散性血管内凝血(DIC)。根据手术和/或尸检结果,每匹马都被回顾性地归类为绞痛的病因:第1组由14匹肠道受损需要切除和吻合的马组成;第2组由3匹非绞窄性肠移位和/或肠阻塞的马组成;第3组由6匹与肠炎和/或结肠炎相关的绞痛的马组成。如果五个止血参数中至少有三个显著异常,则认为马患有DIC:抗凝血酶III(AT III)值降低、纤维蛋白降解产物(FDP)水平升高、血小板减少、活化部分凝血活酶时间延长和凝血酶原时间延长。最一致的止血异常是AT III活性降低、FDP滴度升高和血小板减少。凝血时间变化更大,并不总是与出血过多相关。7匹马在手术期间出现出血过多,另外9匹马在手术后1至12小时内出现出血过多。除了治疗原发性疾病外,19匹马接受了DIC治疗,包括肝素和/或血浆或新鲜全血输血。12匹马单独使用肝素。4匹马除了输注新鲜全血或新鲜血浆外还使用了肝素。3匹马仅接受血浆治疗。另外4匹马未针对DIC进行特殊治疗。8匹马(34%)在急性凝血病中存活下来。虽然存活的马接受肝素治疗的比例(87.5%;7/8)高于死亡的马(60%;9/15),但差异无统计学意义(P = 0.345)。(摘要截断于250字)