Miyata T, Tada Y, Takagi A, Oshima A, Shirakawa M, Idezuki Y
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
J Cardiovasc Surg (Torino). 1988 Jul-Aug;29(4):494-7.
A 71-year-old male with disseminated intravascular coagulation (DIC) caused by abdominal aortic aneurysm was successfully treated surgically. He had aortic regurgitation, an old myocardial infarction, and nephrotic syndrome. The infrarenal part of the inferior vena cava, which was on the left side of the aneurysm, was temporarily transected during the surgical procedure. Preoperative heparin therapy was insufficient, but infusion of blood components during the operation and minimal dissection of the aneurysm were effective in controlling intraoperative hemorrhage. Hypofibrinogenemia and thrombocytopenia were normalized immediately after operation, and hemorrhagic diathesis was completely cured. In this case, the definitive treatment of DIC caused by an abdominal aortic aneurysm war removal of the lesion and the infusion of coagulation factors during the operation was effective in minimizing blood loss.
一名71岁男性因腹主动脉瘤导致弥散性血管内凝血(DIC),接受手术治疗成功。他患有主动脉瓣关闭不全、陈旧性心肌梗死和肾病综合征。在手术过程中,位于动脉瘤左侧的下腔静脉肾下段被暂时横断。术前肝素治疗不足,但术中输注血液成分以及对动脉瘤进行最小限度的剥离对控制术中出血有效。术后低纤维蛋白原血症和血小板减少症立即恢复正常,出血倾向完全治愈。在这种情况下,对腹主动脉瘤引起的DIC的确定性治疗是切除病变,术中输注凝血因子对减少失血有效。