Key words low molecular weight liver tumor disseminated intravascular coagulation
January 2003 to December 2006 in our hospital with the treatment of malignant tumors of the low molecular weight heparin with diffuse intravascular coagulation (DIC) 40 patients achieved good effect, are as follows.
1 Materials and Methods
1.1 General Information Select our hospital from January 2003 to December 2006 were diagnosed as malignant merger of DIC 40 patients with acute leukemia 10 cases, 8 cases of lung cancer, lymphoma, 6 cases, 6 cases of liver cancer, multiple myeloma 3 cases, 3 cases of gastric cancer, 2 cases of ovarian cancer, pancreatic cancer two cases. 28 males and 12 females. Age 35 to 70 years old, All cases were confirmed the pathology and Guchuan smear DIC diagnostic criteria according to the literature .
1.2 Methods 40 patients diagnosed malignancy with DIC 5 000nl/cl subcutaneous injection of low molecular weight heparin, and pre-treatment of the primary disease. Complications of the condition of patients using platelet transfusions, cryoprecipitate. Medication during the dynamic observation of hemorrhage and embolism, daily monitoring of platelet (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg) protamine sulfate test (3P) fibrin degradation products (FDP) and D-dimer (DD). Low molecular weight heparin application to clinical manifestations disappear DIC experimental index returned to normal three days after the withdrawal.
1.3 The evaluation, with reference to the the domestic DIC efficacy standards.
24 cases were cured, effective in 6 cases, 5 cases ineffective, the total effective rate of 75%, disappeared five days after treatment with low-molecular-weight heparin bleeding, embolization improved the treatment of non-one cases of increased bleeding, low molecular weight heparin laboratory parameters before and after treatment Changes are shown in Table 1. Changes in laboratory parameters in Table 140 cases of malignant tumors with DIC patients before and after treatment
Bleeding is the most serious complication of advanced malignancies, an important reason is associated with DIC, the mechanism is quite complex, is a one of the important reasons advanced malignancies death. Therapy DLC fundamental measures is the removal of the primary disease and anticoagulant therapy, anti-fiber treatment, supplement the comprehensive treatment of platelets and clotting factor replacement therapy. Heparin anticoagulant therapy treatment is the key to this group of low molecular weight heparin, low molecular weight heparin lysis by unfractionated heparin or low molecular weight fragments isolated, its anti-Xa activity of antithrombin ratio of 4:1, with both to prevent clotting without aggravating the bleeding good results. Low molecular weight heparin on platelet inhibition and reduced vascular permeability , and the higher bioavailability, longer half-life, need only a small dose daily subcutaneous administration can be in the conventional case, poor reactions, good security. This group was 75%, more effective. Statistically P <0.05, the difference was statistically significant. After treatment than before treatment of coagulation and fiber indicators improved significantly, and no significant bleeding tendency and other adverse reactions, low molecular weight heparin treatment of malignant tumors complicated with DIC convenient, safe, cost-effective, and should be widely applied.