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[FOY疗法治疗与神经外科疾病相关的弥散性血管内凝血或弥散性血管内凝血前期的评估]

[Evaluation of FOY therapy for DIC or pre-DIC associated with neurosurgical disease].

作者信息

Wakui K, Takemae T, Kobayashi S

机构信息

Department of Neurosurgery, Iiyama Red Cross Hospital, Iiyama, Nagano Prefecture.

出版信息

No Shinkei Geka. 1990 Jul;18(7):609-17.

PMID:2118601
Abstract

Disseminated intravascular coagulation (DIC) is not a rare phenomenon in the neurosurgical field. We investigated the therapeutic effect of [Ethyl p - (6-guanidinohexanoyloxy) benzoate] methanesulfonate (FOY) for DIC or Pre-DIC states associated with neurosurgical disorders. During the previous three and half years, a total of 52 cases have been admitted to Shinshu University Hospital and its affiliated hospitals with DIC or Pre-DIC states due to brain disorders (group A) associated with head injuries (19 cases), subarachnoid hemorrhages caused by ruptured aneurysm (12 cases), intracranial hemorrhages and infarctions (5 cases), arteriovenous malformations (2 cases) and spinal cord injury (1 case), and with those states due to brain and another disorders (group B) associated with infections (7 cases), shocks (2 cases) and intoxications by drugs (2 cases). FOY was administered continuously for all patients. Clinical manifestations and laboratory data were analyzed statistically. Platelet count improved from during the 7th to the 10th day after starting FOY. It improved significantly in cases with a high DIC score and the improvement was not influenced by platelet transfusion. FDP, fibrinogen, prothrombin time and antithrombin-III also improved. DIC score remarkably improved in cases with an initial high DIC score. Hemorrhagic symptoms were recognized in 19 cases before administration of FOY and 14 of them (74%) improved after the treatment. Dysfunction of organs was recognized in 28 cases, of which 5 cases (18%) improved. Twenty-nine of 52 cases (56%) were still alive. Only two patients died due to DIC. There were no side effects associated with administration of FOY.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

弥散性血管内凝血(DIC)在神经外科领域并非罕见现象。我们研究了甲磺酸盐[对-(6-胍基己酰氧基)苯甲酸乙酯](FOY)对与神经外科疾病相关的DIC或DIC前期状态的治疗效果。在过去三年半的时间里,共有52例因脑部疾病(A组)合并头部受伤(19例)、动脉瘤破裂引起的蛛网膜下腔出血(12例)、颅内出血和梗死(5例)、动静脉畸形(2例)以及脊髓损伤(1例),以及因脑部和其他疾病(B组)合并感染(7例)、休克(2例)和药物中毒(2例)而出现DIC或DIC前期状态的患者入住信州大学医院及其附属医院。所有患者均持续使用FOY治疗。对临床表现和实验室数据进行了统计学分析。血小板计数在开始使用FOY后的第7至10天有所改善。在DIC评分高的病例中改善显著,且改善不受血小板输注的影响。纤维蛋白降解产物(FDP)、纤维蛋白原、凝血酶原时间和抗凝血酶III也有所改善。初始DIC评分高的病例中DIC评分显著改善。在使用FOY前有19例出现出血症状,其中14例(74%)在治疗后有所改善。28例出现器官功能障碍,其中5例(18%)有所改善。52例中有29例(56%)仍然存活。仅2例患者死于DIC。使用FOY未出现副作用。(摘要截选至250字)

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