急性主动脉综合征并发弥漫性血管内凝血的临床研究

发布时间：2018-01-31 14:24

本文关键词： 急性主动脉综合征弥漫性血管内凝血心脏外科手术　出处：《临床心血管病杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的:通过回顾性分析急性主动脉综合征(AAS)合并弥漫性血管内凝血(DIC)患者诊断、治疗及预后。方法:回顾性分析大连医科大学附属第一医院2013-05-2017-05收治的232例AAS住院患者的临床资料。其中全部入选患者根据其是否合并DIC分为AAS合并DIC组(AAS-DIC组)和AAS未合并DIC组(AAS组),比较两组之间临床特点的差异。结果:对于入组的232例AAS患者中,合并DIC共有19例(8.2%),患者预后不佳。其中10例入院时确诊DIC患者中,5例行外科手术治疗,3例死亡;5例保守治疗患者全部死亡。9例外科术后合并DIC患者中,5例死亡。AAS组及AAS-DIC组DIC筛选指标均存在显著性差异,对于外科手术术后合并DIC组,引流量存在及ICU滞留时间存在显著差异,但体外循环手术时间及停止循环时间方面均无明显差异。结论:AAS易导致DIC的发生,外科手术治疗对于救治AAS合并DIC患者虽然有效,但不能显著改善该类患者的预后。
[Abstract]:Objective: to retrospectively analyze the diagnosis of acute aortic syndrome (AAS) with diffuse intravascular coagulation (DIC). Treatment and prognosis. Methods:. The clinical data of 232 patients with AAS admitted in the first affiliated Hospital of Dalian Medical University 2013-05-2017-05 were retrospectively analyzed. All the patients were selected according to whether they were associated with DIC or not. Divided into AAS combined with DIC group (. (AAS-DIC group) and AAS group (not combined with DIC group). Results: among 232 patients with AAS, there were 19 cases with DIC. The prognosis of the patients was poor. Of the 10 patients diagnosed as DIC at admission, 3 died from surgical treatment in 5 of them. There were significant differences in DIC screening indexes between AAS-DIC group and AAS-DIC group in 5 patients who died in all 9 cases of conservative treatment and 9 cases of patients with DIC after surgery. There were significant differences in drainage and ICU retention time in DIC group after surgery. However, there was no significant difference in the time of CPB operation and the time of stopping circulation. Conclusion DIC is easy to occur as a result of DIC. Surgical treatment is effective in the treatment of AAS patients with DIC. However, the prognosis of these patients could not be improved significantly.
【作者单位】：大连医科大学附属第一医院心脏重症监护病房;大连医科大学附属第一医院心血管内科;
【分类号】：R543.1;R554.8
【正文快照】： 急性主动脉综合征(Acute　aortic　syndrome,AAS)是一种大血管的急症,其主要包括主动脉壁内血肿(Intrarmural　hematoma,IMH)、穿透性主动脉粥样硬化性溃疡(Penetrating　atherosclerotic-ulcer,PAU)、主动脉夹层(Aortic　dissection,AD)。诊断主动脉夹层的主要影像方法有:CT

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