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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。
Objective: To retrospectively analyze the diagnosis, treatment and prognosis of patients with acute aortic syndrome (AAS) and disseminated intravascular coagulation (DIC). Methods: The clinical data of 232 AAS hospitalized patients admitted to the First Affiliated Hospital of Dalian Medical University from May 2013 to May 2017-05 were retrospectively analyzed. All patients were divided into AAS combined with DIC group (AAS-DIC group) and AAS without combined DIC group (AAS group) according to whether they were combined with DIC, and the differences of clinical features between the two groups were compared. RESULTS: Of the 232 AAS patients enrolled, 19 (8.2%) had combined DIC and had a poor prognosis. Of the 10 patients diagnosed with DIC at admission, 5 were treated surgically and 3 died. All 5 conservative patients died. Of the 9 patients with DIC who underwent surgery, 5 died. There were significant differences in DIC screening index between AAS group and AAS-DIC group. There were significant differences in DIC group, drainage volume and ICU residence time after surgery, but there was no significant difference between the two groups in the duration of cardiopulmonary bypass and the time of stopping circulation . Conclusion: AAS can easily lead to the occurrence of DIC. Although surgical treatment is effective for the treatment of AAS with DIC, it can not significantly improve the prognosis of these patients.