Barret Juan P, Gomez Pablo A
St Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, Essex, UK.
Burns. 2005 May;31(3):354-7. doi: 10.1016/j.burns.2004.11.006. Epub 2005 Jan 21.
Severe burns are traditionally quoted as causes for acute disseminated intravascular coagulopathy (DIC). However, literature is scarce, and the real incidence of DIC is still unknown. In order to determine the incidence and the clinical implications of DIC in the burned population, 3331 consecutive burned patients were review. There were three episodes of DIC (0.09%) and six patients had abnormal levels of fibrin degradation products. All DIC episodes resolved with aggressive supportive therapy and replacement therapy, although two of the patients died from the underlying pathology. There were no deaths attributed to DIC and there were no signs of DIC on autopsy. In conclusion, disseminated intravascular coagulopathy is a rare complication following severe burn trauma. It complicates the course of the critically ill burn patient, although appropriate therapy prevents its fulminant course. However, a prospective multicenter study with close monitoring of all coagulation parameters may be necessary to elucidate the real incidence of DIC in burn patients.
严重烧伤传统上被认为是急性弥散性血管内凝血(DIC)的病因。然而,相关文献稀少,DIC的实际发病率仍不清楚。为了确定烧伤人群中DIC的发病率及其临床意义,我们回顾了3331例连续烧伤患者的病例。其中有3例发生DIC(0.09%),6例患者纤维蛋白降解产物水平异常。尽管有2例患者死于基础疾病,但所有DIC病例均通过积极的支持治疗和替代疗法得到缓解。没有因DIC导致的死亡病例,尸检也未发现DIC迹象。总之,弥散性血管内凝血是严重烧伤创伤后一种罕见的并发症。它使重症烧伤患者的病程复杂化,尽管适当的治疗可防止其发展为暴发性病程。然而,可能需要进行一项对所有凝血参数进行密切监测的前瞻性多中心研究,以阐明烧伤患者中DIC的实际发病率。