糖尿病患者败血症诱发弥散性血管内凝血的治疗策略  

Treatment strategies of sepsis-induced disseminated intravascular coagulation in diabetes mellitus patients

作　　者：蒋鸿阳[1] 杨杰[1] 王清[1] 

机构地区：[1]吉林大学中日联谊医院内分泌科,吉林长春130033

出　　处：《中华医院感染学杂志》2013年第14期3372-3373,3376,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨糖尿病并发败血症患者发生弥散性血管内凝血(DIC)的治疗策略,为临床治疗提供参考。方法分析1例糖尿病并发败血症患者的病例资料,比较其治疗前后症状、体征及辅助检查等方面的变化。结果治疗前血中白细胞9.42×109/L,中性粒细胞8.13×109/L,血小板32×109/L,纤维蛋白原定量4.36g/L,D-二聚体定量4559.0ng/ml;治疗后白细胞8.46×109/L,中性粒细胞6.49×109/L,血小板225×109/L,纤维蛋白原定量及D-二聚体定量正常。结论 DIC的治疗应在积极治疗原发病及充分对症支持治疗的基础上适当应用抗栓药物,近年来活化蛋白C和凝血调节蛋白也逐渐成为治疗的新手段。OBJECTIVE To discuss the treatment strategies of the sepsis-induced disseminated intravascular coagulation（DIC）in diabetes mellitus patients so as to provide basis for the clinical therapy.METHODS The medical records of 1diabetes mellitus patient complicated with sepsis were analyzed,then the symptoms,physical signs,and auxiliary tests were observed before and after the treatment.RESULTS Before the treatment,the count of white blood cell was 9.42×109/L,neutrophil 8.13×109/L,platelet 32×109/L,FIB 4.36g/L,D-dimer 4559.0ng/ ml;after the treatment,the count of white blood cell was 8.46×109/L,neutrophil 6.49×109/L,platelet 225× 109/L,FIB and D-dimer normal.CONCLUSION The DIC should be treated with reasonable use of antibiotics on the basis of the active treatment of primary disease and the symptomatic and supportive treatment.In recent years,the activated protein C and thrombomodulin tend to be the new treatment strategies.

关 键 词：糖尿病 败血症 弥散性血管内凝血 

分 类 号：R181.32[医药卫生—流行病学]