Preoperative disseminated intravascular coagulation associated with aortic aneurysms. A prospective study of 76 cases.
Preoperative disseminated intravascular coagulation associated with aortic aneurysms. A prospective study of 76 cases.
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术前与主动脉瘤相关的弥散性血管内凝血。
DOI：
10.1001/archsurg.1983.01390110010002
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发表时间：
1983
影响因子：
--
通讯作者：
E. Crawford
中科院分区：
文献类型：
--
作者：
D. Fisher;D. Yawn;E. Crawford
对76例术前患有主动脉瘤的患者进行了前瞻性研究，以确定相关弥散性血管内凝血（DIC）的真实发生率。虽然39%的患者显示纤维蛋白裂解产物水平显著升高，但只有3例患者同时具有血小板减少症和临床出血素质。因此，只有4%的患者在术前发生临床上明显的DIC。所有三名患者均患有累及胸腹主动脉的广泛动脉瘤。术前纤维蛋白原水平在这一系列往往是高正常或升高，并不是潜在的过度纤维蛋白溶解的良好指标。止血异常，如瘀斑和瘀点，可能是临床诊断主动脉瘤患者术前DIC的关键。
A prospective study of 76 preoperative patients with aortic aneurysms was undertaken to determine the true incidence of associated disseminated intravascular coagulation (DIC). Although 39% of the patients showed a notable elevation of the fibrin split products level, only three had thrombocytopenia and a clinical bleeding diathesis, as well. Thus, clinically overt DIC occurred preoperatively in only 4% of the patients. All three patients had extensive aneurysms that involved the thoracoabdominal aorta. Preoperative fibrinogen levels in this series tended to be high-normal or elevated and were not good indicators of underlying excessive fibrinolysis. Hemostatic abnormalities, such as ecchymoses and petechiae, may be the key to the clinical diagnosis of DIC in preoperative patients with aortic aneurysms.