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腹主动脉瘤合并慢性弥散性血管内凝血:一例手术治疗病例

Abdominal aortic aneurysm complicated with chronic disseminated intravascular coagulopathy: a case of surgical treatment.

作者信息

Mukaiyama H, Shionoya S, Ikezawa T, Kamiya T, Hamaguchi M, Saito H

机构信息

First Department of Surgery, Nagoya University, School of Medicine, Japan.

出版信息

J Vasc Surg. 1987 Dec;6(6):600-4. doi: 10.1067/mva.1987.avs0060600.

Abstract

This article reports a case of an infrarenal abdominal aortic aneurysm complicated with chronic disseminated intravascular coagulopathy (DIC). The patient was a 68-year-old man; bleeding of 20 months' duration was reported. Physical examination indicated a pulsating mass in the abdomen. The diagnosis of DIC was made on the basis of standard coagulation studies. Indium 111-labeled platelet scintigraphy demonstrated an increased accumulation of radioactivity over the aneurysm. After preoperative control of the bleeding tendency was obtained by continuous intravenous infusion of gabexate mesilate (FOY), the aneurysm was successfully replaced with a prosthetic graft. Gabexate mesilate therapy is useful for DIC as is heparin therapy. If surgical intervention is required for an abdominal aortic aneurysm with concomitant DIC, preoperative control of bleeding with gabexate mesilate or heparin is recommended to lessen operative bleeding.

摘要

本文报道了一例肾下腹主动脉瘤合并慢性弥散性血管内凝血(DIC)的病例。患者为一名68岁男性,有长达20个月的出血症状。体格检查发现腹部有搏动性肿块。根据标准凝血研究做出了DIC的诊断。铟111标记的血小板闪烁显像显示动脉瘤部位放射性积聚增加。通过持续静脉输注甲磺酸加贝酯(FOY)术前控制出血倾向后,成功地用人造血管替换了动脉瘤。甲磺酸加贝酯治疗DIC与肝素治疗一样有效。如果伴有DIC的腹主动脉瘤需要手术干预,建议术前用甲磺酸加贝酯或肝素控制出血,以减少手术出血。

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