Hinata S, Kawada T, Andou N, Hoson M, Okada T, Yamate N
Third Department of Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Mar;39(3):336-40.
This article reports a case of a thoracoabdominal aneurysm complicated with disseminated intravascular coagulopathy (DIC). The thoracoabdominal aneurysm was successfully replaced with a prosthetic graft following the short terms of heparin pretreatment. Although heparin pretreatment had been effective for the temporal remission of DIC, a large amount of blood transfusion was necessary because of prolonged bleeding from surgical wound. However, hematological evidence of DIC and bleeding tendency were dramatically arrested in the immediate postoperative period. It was concluded that the definitive treatment for DIC was removal of the aneurysm. Heparin was usefull for the preservation of coagulation factors and platelet, but it did not lessen operative bleeding.
本文报道了一例胸腹主动脉瘤合并弥散性血管内凝血(DIC)的病例。在短期肝素预处理后,成功地用人工血管置换了胸腹主动脉瘤。尽管肝素预处理对DIC的暂时缓解有效,但由于手术伤口持续出血,仍需要大量输血。然而,术后即刻DIC的血液学证据和出血倾向显著停止。得出的结论是,DIC的确定性治疗是切除动脉瘤。肝素有助于保存凝血因子和血小板,但并不能减少手术出血。