[Evaluation of FOY therapy for DIC or pre-DIC associated with neurosurgical disease].
Disseminated intravascular coagulation (DIC) is not a rare phenomenon in the neurosurgical field. We investigated the therapeutic effect of [Ethyl p - (6-guanidinohexanoyloxy) benzoate] methanesulfonate (FOY) for DIC or Pre-DIC states associated with neurosurgical disorders. During the previous three and half years, a total of 52 cases have been admitted to Shinshu University Hospital and its affiliated hospitals with DIC or Pre-DIC states due to brain disorders (group A) associated with head injuries (19 cases), subarachnoid hemorrhages caused by ruptured aneurysm (12 cases), intracranial hemorrhages and infarctions (5 cases), arteriovenous malformations (2 cases) and spinal cord injury (1 case), and with those states due to brain and another disorders (group B) associated with infections (7 cases), shocks (2 cases) and intoxications by drugs (2 cases). FOY was administered continuously for all patients. Clinical manifestations and laboratory data were analyzed statistically. Platelet count improved from during the 7th to the 10th day after starting FOY. It improved significantly in cases with a high DIC score and the improvement was not influenced by platelet transfusion. FDP, fibrinogen, prothrombin time and antithrombin-III also improved. DIC score remarkably improved in cases with an initial high DIC score. Hemorrhagic symptoms were recognized in 19 cases before administration of FOY and 14 of them (74%) improved after the treatment. Dysfunction of organs was recognized in 28 cases, of which 5 cases (18%) improved. Twenty-nine of 52 cases (56%) were still alive. Only two patients died due to DIC. There were no side effects associated with administration of FOY.(ABSTRACT TRUNCATED AT 250 WORDS)
Wakui
K
K
Department of Neurosurgery, Iiyama Red Cross Hospital, Iiyama, Nagano Prefecture.
Takemae
T
T
Kobayashi
S
S
D000925:Anticoagulants / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D004341:Drug Evaluation; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D016670:Gabexate; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications* / Q000601:surgery; D010976:Platelet Count / Q000187:drug effects; D011379:Prognosis; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006146:Guanidines; D015842:Serine Proteinase Inhibitors; D016670:Gabexate