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[使用移动输液泵持续皮下输注肝素成功治疗慢性播散性血管内凝血综合征:2例报告]

[Successful treatment of chronic disseminated intravascular coagulation syndrome with continuous subcutaneous infusion of heparin using a mobile infusion pump: report of 2 cases].

作者信息

Togami Katsuhiro, Nagai Yuya, Arima Hiroshi, Shimoji Sonoko, Kimura Takahiro, Inoue Daichi, Mori Minako, Fujita Haruyuki, Tabata Sumie, Kurata Masayuki, Yanagida Soshi, Matsushita Akiko, Nagai Kenichi, Kaji Shuichiroh, Takahashi Takayuki

机构信息

Department of Hematology, Kobe City Medical Center, General Hospital.

出版信息

Rinsho Ketsueki. 2009 Dec;50(12):1700-5.

Abstract

We report here two patients with chronic disseminated intravascular coagulation (chronic DIC) secondary to aortic aneurysm, who were successfully treated with continuous subcutaneous infusion of heparin. The patients were 69- and 89-year-old males, who were admitted to our hospital because of thrombocytopenia and marked bleeding tendency. The underlying conditions were aortic dissection and aortic aneurysm, respectively. Coagulation test demonstrated that these patients had DIC, and a diagnosis of chronic DIC secondary to aortic aneurysm was made. Anti-coagulation treatment with oral camostat mesylate and daily subcutaneous infusion of heparin calcium was started. However, the treatment was insufficient to control chronic DIC, and these patients developed recurrent severe subcutaneous hemorrhages. Therefore, we attempted continuous subcutaneous infusion of heparin using a mobile infusion pump. This delivery of heparin markedly improved the coagulopathy, and the hemorrhagic episode disappeared with good compliance in the use of infusion equipment in these patients. Continuous subcutaneous infusion of heparin using a mobile infusion pump is effective and useful for long term treatment of chronic DIC by the outpatient department.

摘要

我们在此报告两例继发于主动脉瘤的慢性弥散性血管内凝血(慢性DIC)患者,他们通过皮下持续输注肝素成功治愈。这两名患者均为男性,年龄分别为69岁和89岁,因血小板减少和明显的出血倾向入院。其潜在病因分别为主动脉夹层和主动脉瘤。凝血检查显示这些患者患有DIC,诊断为继发于主动脉瘤的慢性DIC。开始使用口服甲磺酸加贝酯及每日皮下注射肝素钙进行抗凝治疗。然而,该治疗不足以控制慢性DIC,这些患者出现了反复的严重皮下出血。因此,我们尝试使用便携式输液泵进行皮下持续输注肝素。这种肝素给药方式显著改善了凝血病,并且在这些患者中,随着输液设备使用的良好依从性,出血事件消失。通过便携式输液泵进行皮下持续输注肝素对于门诊长期治疗慢性DIC是有效且有用的。

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