PHÂN TÍCH ĐẶC ĐIỂM CỦA BỆNH NHÂN ĐÔNG MÁU RẢI RÁC NỘI MẠCH CẤP ĐIỀU TRỊ TẠI KHOA HỒI SỨC CẤP CỨU – BỆNH VIỆN K

Abstract

Objective: Describe the clinical and paraclinical characteristics of acute Disseminated Intravascular Coagulation (DIC) patients. Methods: Cross-sectional study on 43 patients diagnosed with acute DIC at the Emergency and Intensive Care Department – Vietnam National Cancer Hospital, from September 2018 to September 2019. Results: The average age is 51.4 ± 15.2, the male/female ratio is 2/1, 79% of patients have solid cancer, 21% have hematopoietic cancer. Up to 35% of DIC patients have not received specific cancer treatment. Bleeding symptoms were up to 81.4%, mainly bleeding in the skin and mucous membranes, the detection rate of thrombosis was 32.6%, mainly vein occlusion. 81.4% of patients showed signs of infection ranging from mild to septic shock. Procalcitonin index increased (average 14.1 ± 31.0). Fibrinogen reduction occurs in 16.3% of patients, thrombocytopenia occurs in 88.4% of patients, prolonged prothrombin time than 6 seconds in 67.4% of patients, and extremely  elevated D-dimer in 93% of patients, but there was not difference between bleeding and without bleeding groups. Conclusion: The most common clinical manifestations of DIC are bleeding and infection. Patients with solid cancers were more common than hematopoietic cancers, with 35% having not received specific cancer treatment. Thrombocytopenia is a common sign, especially in patients with bleeding. Other coagulation tests (PTs, D-dimer) were elevated and decreased fibrinogen was seen only in a small number of patients.