Shiba T
Nihon Geka Gakkai Zasshi. 1983 Sep;84(9):873-7.
The records of 27 cases of disseminated intravascular coagulation with burn, trauma, perforated peritonitis or leakage of gastrointestinal anastomoses at the Second Department of Surgery and Intensive Care Unite, Toho University Hospital from 1977 to 1982 were reviewed. In this series, multiple organ failure (MOF) occurred in 20 cases and single organ failure occurred in 4 cases. Lung failure occurred in 20 out of 27 cases. Renal failure occurred in 18 out of 27 cases. Then, correlation was observed between decrease in platelet count and decrease in PaO2/FiO2. Serum creatinine level and total bilirubin level were elevated according to the progress of DIC. Twenty death cases with DIC out of 21 had MOF. However, 3 survived cases out of 6 cases had only single organ failure and other 3 survived cases out of 6 cases had not organ failure. Therefore, close correlation was observed between DIC and MOF in the prognosis of DIC. Earlier and active support of organ failure was important for clinical management of DIC.
回顾了1977年至1982年东京大学医院外科第二科室及重症监护室收治的27例因烧伤、创伤、腹膜炎穿孔或胃肠吻合口漏导致的弥散性血管内凝血病例记录。在该系列病例中，20例发生多器官功能衰竭（MOF），4例发生单器官功能衰竭。27例中有20例发生肺功能衰竭。27例中有18例发生肾功能衰竭。然后，观察到血小板计数下降与PaO2/FiO2下降之间存在相关性。血清肌酐水平和总胆红素水平随着弥散性血管内凝血的进展而升高。21例弥散性血管内凝血死亡病例中有20例发生多器官功能衰竭。然而，6例存活病例中有3例仅发生单器官功能衰竭，另外6例存活病例中有3例未发生器官功能衰竭。因此，在弥散性血管内凝血的预后中，观察到弥散性血管内凝血与多器官功能衰竭之间存在密切相关性。早期积极支持器官功能衰竭对弥散性血管内凝血的临床管理很重要。
