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目的探讨妊娠期急性脂肪肝继发播散性血管内凝血的早期诊治方法。方法回顾性分析4例妊娠期急性脂肪肝继发播散性血管内凝血患者的临床资料。结果 4例患者孕周为33～37周;首发症状均为乏力、厌食、胃部烧灼感,喜冷饮;入院后实验室检查结果示凝血四项均延长,3P实验均呈阳性;患者经静脉输入全血、血浆及纤维蛋白原治疗后,DIC于确诊后4～16d逆转。结论早期识别并治疗妊娠期急性脂肪肝继发播散性血管内凝血是降低孕产妇病死率、改善预后的关键。
Objective To investigate the early diagnosis and treatment of disseminated intravascular coagulation secondary to acute fatty liver in pregnancy. Methods The clinical data of 4 patients with disseminated intravascular coagulation secondary to fatty liver during pregnancy were retrospectively analyzed. Results The gestational age of the 4 patients was 33-37 weeks. The first symptom was fatigue, anorexia, burning sensation in the stomach and hi-cold drink. The results of laboratory tests after admission showed that all of the four were prolonged, and the 3P test was positive. Enter the whole blood, plasma and fibrinogen after treatment, DIC 4 ~ 16d after diagnosis reversal. Conclusion Early identification and treatment of disseminated intravascular coagulation secondary to acute fatty liver during pregnancy is the key to reduce maternal mortality and improve prognosis.