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肝素、低分子肝素诱导的重症血小板减少2例救治分析
引用本文:余茂生,盛国太,谢国波,李华泰,葛郁芝.肝素、低分子肝素诱导的重症血小板减少2例救治分析[J].医学与哲学,2014(10):63-64.
作者姓名:余茂生  盛国太  谢国波  李华泰  葛郁芝
作者单位:江西省人民医院心内科/江西省心血管病研究所,江西南昌330006
摘    要:探讨肝素/低分子肝素诱导的重症血小板减少救治经验与规律.对2例分别使用肝素、低分子肝素后出现重症血小板减少患者发病、临床特征、实验室检查等进行分析,进一步提高该类重症病的认识,总结救治经验:严密监测,早期发现,一旦出现重症血小板减少,及时停用肝素和/或低分子肝素,换用非肝素类抗凝药;立即激素(地塞米松30mg/d)冲击治疗2天,重症血小板减少(PLT≤3×109/L)并出血者酌情输注血小板.

关 键 词:肝素  低分子肝素  重症血小板减少

Analysis to Successful Rescue of Two Serious Unfractioned Heparin-/Low Molecular Weight Heparin-induced Thrombocytopenic Patients
Institution:YU Mao-sheng,SHENG Guo-tai,XIE Guo-bo( 1.The Vasculocardiology Department of the Public People's Hospital of Jiangxi Province, and the Angiocardiopathy Institute of Jiangxi Province,Nanchang 330006, China)
Abstract:To investigate how the serious thrombocytopenia of unfractioned heparin(UFH) /low molecular weight heparin (LMWH) induced happen in some patients and what we can rescue them with.Analyzing the incidence,clinical features and laboratory examination of two patients who suffered from the serious thrombocytopenia of UFH /LMWH induced,we can deepen the understanding of the disease,and we could sum up the rescue experience that the patient should be closely monitored,and should be early diagnosed and treated.In the same time,we must timely teminate the utilization of UFH and LMWH,we should give non-heparin anticoagulant drug,and also early timely utilize large dose dexamethasone within two days (30mg/d× 2).In the end,the serious thrombocytopenic patients(PLT≤3 × 109/L) who accompanied by haemorrhage should be carefully given blood platelet transfusion.
Keywords:unfractioned heparin(UFH)  low molecular weight heparin(LMWH)  serious thrombocytopenia
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