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[急性消耗性凝血病。120例]

[Acute consumption coagulopathies. 120 cases].

作者信息

Larcan A, Lambert H, Laprevote-Heully M C, Alexandre P, Gerbaux A

出版信息

Nouv Presse Med. 1976 Dec 4;5(41):2771-6.

PMID:995606
Abstract

Consumption coagulopathy is frequently observed in a resuscitation department. 120 cases of various etiologies are reviewed: complications of pregnancy (61 cases), infections (23 cases) or various stresses: acute hemolysis, shock, severe hepatic failure, intoxications, acidosis, heat-stroke... Consumption coagulopathy is intricated with the general stress which induces it, and with the visceral lesions induced by the stress and which can be aggravated by the consumption coagulopathy. The state of shock is observed in 76% of the cases, the haemorrhagic syndrome in 73%. Acute hemolysis and the clinical signs evocative of disseminated intravascular coagulation (cutaneous signs) are more rare. Following the initial manifestations, visceral complications may develop: renal, hepatic, respiratory, neurological, digestive. The evolution of the biology must be carefully studied. The diagnosis is made on both clinical and biological data. Etiological and pathophysiological treatment should be carried out. In our series, controlled and adapted heparin therapy was given systematically.

摘要

消耗性凝血病在复苏科室较为常见。回顾了120例各种病因的病例:妊娠并发症(61例)、感染(23例)或各种应激因素:急性溶血、休克、严重肝功能衰竭、中毒、酸中毒、中暑……消耗性凝血病与引发它的全身应激以及应激诱导的内脏病变错综复杂,且这些内脏病变可能因消耗性凝血病而加重。76%的病例出现休克状态,73%出现出血综合征。急性溶血和提示弥散性血管内凝血的临床体征(皮肤体征)较为少见。在初始表现之后,可能会出现内脏并发症:肾脏、肝脏、呼吸、神经、消化系统并发症。必须仔细研究生物学指标的变化情况。诊断基于临床和生物学数据。应进行病因和病理生理治疗。在我们的系列病例中,系统性地给予了可控且合适的肝素治疗。

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