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目的 探讨肝癌介入治疗后并发弥散性血管内凝血 (DIC)的原因、预防措施、临床检查及治疗。方法 原发性肝癌病人 3例 ,均接受经导管肝动脉化疗栓塞治疗。结果 3例病人均出现穿刺点出血、血肿 ,静脉输液部位淤斑 ,1例伴口腔黏膜出血并颌下血肿。实验室检查显示血小板计数进行性下降 ,凝血酶原时间、激活的部分凝血活酶时间延长 ,纤维蛋白原降解产物、D 二聚体值升高。经治疗后 ,2例好转出院 ,1例因多器官功能衰竭而死亡。结论 肝癌介入治疗后所发生的DIC是一种少见而严重的并发症 ,且死亡率较高。因此 ,对可疑凝血机制障碍的病人 ,在介入治疗前后应加强观察 ,及时进行实验室检查 ,以期早期发现 ,及时处理
Objective To investigate the causes, preventive measures, clinical examination and treatment of disseminated intravascular coagulation (DIC) after hepatic cancer interventional therapy. Methods Three patients with primary liver cancer received transcatheter hepatic arterial chemoembolization. Results All the 3 patients showed puncture point hemorrhage, hematoma, ecchymosis of venous infusion site, and 1 patient with oral mucosal hemorrhage and submandibular hematoma. Laboratory tests showed progressive decline in platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen degradation products, D dimer value increased. After treatment, 2 patients were discharged and 1 patient died of multiple organ failure. Conclusion DIC occurred after interventional treatment of liver cancer is a rare and serious complication, and the mortality rate is high. Therefore, suspected coagulation disorders in patients before and after intervention should be strengthened observation, timely laboratory tests, with a view to early detection and timely treatment