You Daniel Z, Kendal Joseph K, Duffy Paul, Monument Michael J, Schneider Prism S
Section of Orthopaedic Surgery, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.
McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
JBJS Case Connect. 2020 Jan-Mar;10(1):e0370. doi: 10.2106/JBJS.CC.19.00370.
We present a case of acute disseminated intravascular coagulation (DIC) after prophylactic femoral intramedullary stabilization in a patient with metastatic prostate cancer. Preoperative international normalized ratio of 1.4 was attributed to malnutrition, and the patient was not medically optimized. DIC developed 1 hour postoperatively and was managed with blood product resuscitation. At the 4-month follow-up, the patient presented with bilateral pulmonary emboli and was transitioned to palliative care.
DIC after intramedullary stabilization in patients with metastatic bone disease is a rare condition with high mortality rate. Early recognition, blood product resuscitation, and involvement of appropriate subspecialty services are imperative in DIC management.
我们报告一例转移性前列腺癌患者在进行预防性股骨髓内固定术后发生急性弥散性血管内凝血（DIC）的病例。术前国际标准化比值为1.4，原因是营养不良，且患者未进行充分的医学优化处理。DIC在术后1小时发生，通过血液制品复苏进行处理。在4个月的随访中，患者出现双侧肺栓塞，并转入姑息治疗。
转移性骨病患者髓内固定术后发生DIC是一种罕见疾病，死亡率高。在DIC的管理中，早期识别、血液制品复苏以及相关专科服务的参与至关重要。
