产科相关弥散性血管内凝血如何诊断和处理  

Diagnosis and management of disseminated intravascular coagulation in obstetrics

作　　者：龚晓莹[1] 臧彬[1] GONG Xiao-ying;ZANG Bin(Department of Critical Care Medicine,Shengjing Hospital,China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院重症医学科,辽宁沈阳110004

出　　处：《中国实用内科杂志》2021年第6期475-479,共5页Chinese Journal of Practical Internal Medicine

基　　金：中华国际医学交流基金会(Z-2017-24-2028-09)。

摘　　要：产科相关弥散性血管内凝血(DIC)是孕产妇死亡的主要原因之一,往往进展迅速,诊断困难,需引起临床医生高度重视。由于妊娠期生理性高凝状态,产科相关DIC诊断需要结合临床表现、妊娠校正的DIC评分和反复的实验室检查结果。如DIC合并产科大出血,优先考虑止血治疗,必要时需手术及大量的血制品替代,充分评估后谨慎使用抗凝或促凝药物。文章将详述产科相关DIC的诊断和处置流程。Disseminated intravascular coagulation(DIC)in obstetrics is one of the main causes of maternal death,which often progresses rapidly and is difficult to diagnose.Due to the physiological hypercoagulability of pregnancy,the diagnosis of obstetrical DIC should be established based on clinical phenotypes,pregnancy modified DIC score and repeated laboratory examinations.If obstetrical DIC is complicated with major hemorrhage,priority should be given to hemostasis.Surgery and massive blood transfusion should be considered when necessary.Anticoagulant or procoagulant drugs should be used after careful evaluation.This current article will present the diagnosis and management of DIC in obstetrics in detail.

关 键 词：产科相关弥散性血管内凝血 诊断 处置 

分 类 号：R554.8[医药卫生—血液循环系统疾病]