Matsuda H, Nakao M, Nohara H, Higami T, Mukohara N, Asada T, Ogawa K
Kyobu Geka. 1989 Nov;42(12):1039-42.
A 75-year-old woman developed general fatigue and left chest pain in October 1986, and Chest CT showed DeBakey IIIb dissecting aneurysm. During the next 8 months, she repeated abdominal pain, tarry stool and subcutaneous hemorrhage for three times and after an angiography large hematoma at puncture site appeared. The laboratory data showed the decrease in platelet and fibrinogen and the increase in FDP every time when she developed the symptoms. Because this bleeding tendency was thought to be the "local DIC" caused by dissecting aneurysm, we performed thromboexclusion on July 27, 1987. Immediately after the operation, 60 packs of platelet and 3 g of fibrinogen was transfused, then laboratory data remarkably improved and bleeding tendency disappeared. The patient died 12 days after the operation of sudden ventricular tachycardia. At autopsy, precise cause of death was not determined, but the purpose of thromboexclusion seemed to be achieved, because good thrombus formation was observed in the descending aorta and the graft was patent.
一名75岁女性于1986年10月出现全身乏力及左胸痛，胸部CT显示为DeBakey IIIb型夹层动脉瘤。在接下来的8个月里，她三次反复出现腹痛、柏油样便及皮下出血，血管造影后穿刺部位出现巨大血肿。每次出现症状时实验室检查数据显示血小板及纤维蛋白原减少，纤维蛋白降解产物增加。由于这种出血倾向被认为是由夹层动脉瘤导致的“局部弥散性血管内凝血”，我们于1987年7月27日进行了血栓排除术。术后立即输注了60单位血小板及3克纤维蛋白原，随后实验室检查数据显著改善，出血倾向消失。患者术后12天死于室性心动过速。尸检时未确定确切死因，但由于在降主动脉观察到良好的血栓形成且移植物通畅，血栓排除术的目的似乎已经达到。
