[Management of coagulation dysfunction in critically surgical patient].

12 surgical critically ill patients were studied for a better management of perioperative coagulation dysfunction. Their primary disease, clinical manifestation as well as some coagulation tests before and after therapy were retrospectively analysed. The result showed that secondary disseminated intravascular coagulation (DIC) is the main type of perioperative coagulation disorder, especially in decompensated hepatopathy and severe sepsis patients. It should be emphasized that: control of primary disease, effective drainage of focus, strict indication for 2nd surgical hemostasis and correct operation are required. For those hepatopathy with hypofibrinogenemia, some hemostatic drugs should be prohibited or very carefully used, in order to avoid the activation of plasmin and the exhaustion of fibrin. The early administration of heparin and aprotinin after the supplement of fibrinogen has shown a great potential benifit to stop the cascade of hypercoagulation and hyperplasminogenemia by enhancing the level of AT-III and fibrinogen in plasma.