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Patofiziologija, diagnostika in terapija diseminirane intravaskularne koagulacije = Pathophysiology, diagnosis and treatment of disseminated intravascular coagulationUrlep-Šalinović, VeronikaIzhodišča: Diseminirana intravaskularna koagulacija (DIK) je trombohemoragična hemostatska motnja, ki se najpogosteje pojavlja v naslednjih bolezenskih stanjih: sepsa, poškodbe, opekline, neskladna ... transfuzija eritrocitov, masivna transfuzija, avtoimunske bolezni, akutna mielocitna in promielocitna levkemija, pankreatitis, pri zapletih v porodništvu (eklampsija, predležeča posteljica, predčasna ločitev pravilno ležeče posteljice, embolija s plodovnico, HELLP sindrom, smrt ploda v maternici in drugi zapleti ob porodu), malignomi z razsevki in jetrne bolezni. DIK je sindrom, ki se klinično zrcali v poškodbi različnih organov zaradi tromboze v mikrocirkulaciji in hudih življenje ogrožajočih krvavitvah zaradi porabe koagulacijskih dejavnikov in trombocitov ter sekundarne aktivacije fibrinoloze. V hemostatskih testih, značilnih za DIK, najdemo, odvisno od stopnje aktivacije koagulacije, neznatno ali celo podaljšan protrombinski čas, podaljšan trombinski čas, podaljšan aktivirani parcialni tromboplastinski čas, znižan fibrinogen, znižane faktorje koagulacije (F II, FV, F VIII), znižan antitrombin III, znižano število trombocitov, zvišan D-dimer. Zaradi naglih sprememb v hemostatskem mehanizmu moramo testiranje ponavljati. Poleg intenzivnega zdravljenjua osnovne bolezni, moramo zaustaviti trombotično dogajanje z uporabo najustreznejših antikoagulantov (majhni odmerki subkutanega heparina, nizkomolekularni heparin, koncentrat AT III, koncentrat aktiviranega (PC) - in nadomestiti porabljene koagulacijske dejavnike in trombocite. Zaključki: DIK je akutea in zelo hud zaplet v različnih patoloških stanjih. Zgodnja diagnoza, ki se postavlja na osnovi klinične slike in laboratorijskih izvidov ob tesnem sodelovanju klinika in laboratorijskega zdravnika, omogoča pravočasno ukrepanje in preprečuje hude zaplete.Source: Hemostatske motnje (Str. 115-128)Type of material - conference contribution ; adult, seriousPublish date - 2006Language - slovenianCOBISS.SI-ID - 2352447
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Urlep-Šalinović, Veronika | 06226 |
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