体表软组织静脉畸形中局限性血管内凝血的临床特征分析  

Clinical features of localized intravascular coagulation in venous malformations

作　　者：韩钰钰 余明薇 王慜 徐媛 陈勇 袁斯明 HAN Yuyu;YU Mingwei;WANG Min;XU Yuan;CHEN Yong;YUAN Siming(Department of Burn and Plastic Surgery,Eastern Theater General Hospital of the People's Liberation Army,Nanjing 210002,China)

机构地区：[1]中国人民解放军东部战区总医院烧伤整形科,江苏省南京市210002

出　　处：《组织工程与重建外科》2022年第3期214-218,237,共6页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：国家自然科学基金(81272989)。

摘　　要：目的 分析静脉畸形伴发局限性血管内凝血(Localized intravascular coagulation,LIC)的临床特征,以加深对该现象的认识。方法 将2019年9月1日至2020年8月31日在东部战区总医院烧伤整形科治疗的41例静脉畸形患者纳入研究。所有患者均行磁共振、超声等检查,以明确病灶部位和面积。抽取循环血和病灶血,检测凝血功能指标,观察有无LIC及凝血功能指标的变化特点,分析LIC与病灶数量、病灶部位、累及组织类型的关系。结果 静脉畸形中LIC主要表现为FIB、FDP、D-dimer、AT3异常。病灶血凝血功能异常的发生率显著高于循环血。多发病灶、躯干和头面部病灶更易发生系统性凝血功能异常。累及组织类型与病灶及系统凝血功能异常没有显著相关性。结论 静脉畸形中LIC主要表现为FIB、FDP、D-dimer、AT3异常;LIC与病灶数量、发生部位显著相关,与病灶累及组织类型无明显相关性;病灶内LIC可能是导致系统性凝血功能异常的原因。Objective To analysis the clinical features of localized intravascular coagulation(LIC) in patients with venous malformation(VM), so as to attach more importance to such phenomena. Methods A total of 41 patients with VMs were included in the study, treated in the Department of Burn and Plastic Surgery in Eastern Theater General Hospital from September 1st, 2019 to August 31st, 2020. All of them were examined by MRI and ultrasound to determine the location and area of the lesions. The blood coagulation profile of lesion and circulation was detected after admission to evaluate LIC and the features. The relationships between the abnormal coagulation profile and the lesion number, location, the tissue involved were analyzed. Results The main manifestations of LIC in VMs were the abnormalities of FIB, FDP, D-dimer and AT3. The incidence of abnormal coagulation indexes of lesion was obviously higher than that of circulation. Multiple, trunk, and craniofacial lesions were more prone to have systemic coagulation abnormalities. There was no significant correlation between the type of tissue involved and the coagulation abnormality in lesion or circulation. Conclusion The main manifestations of LIC in VMs are the abnormalities of FIB, FDP, D-dimer and AT3. LIC is significantly correlated with the number and location of lesions, but not the types of tissues involved. LIC in the lesion is probably the cause of abnormal systemic coagulation.

关 键 词：静脉畸形 局限性血管内凝血 D-二聚体 纤维蛋白原降解产物 

分 类 号：R732.2[医药卫生—肿瘤]