Hogan W J, McBane R D, Santrach P J, Plumhoff E A, Oliver W C, Schaff H V, Rodeheffer R J, Edwards W D, Duffy J, Nichols W L
Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2000 Sep;75(9):971-6. doi: 10.4065/75.9.971.
Hemostatic aspects of antiphospholipid syndrome (APS) present unique challenges to clinicians and laboratory personnel alike, particularly in the perioperative period. These challenges are especially evident in patients requiring cardiac valve replacement surgery. However, the literature outlining the optimal approach in such patients is limited. We present the case of a 25-year-old woman with severe aortic regurgitation as a result of APS with particular reference to the precautions necessary during perioperative care. Particularly important are the prevention of thrombotic or hemorrhagic complications, management of associated thrombocytopenia, and laboratory methods of perioperative anticoagulation monitoring in the setting of prolonged clotting times.
抗磷脂综合征（APS）的止血方面给临床医生和实验室人员都带来了独特的挑战，尤其是在围手术期。这些挑战在需要进行心脏瓣膜置换手术的患者中尤为明显。然而，概述此类患者最佳治疗方法的文献有限。我们介绍了一名25岁因APS导致严重主动脉瓣反流的女性病例，并特别提及围手术期护理所需的预防措施。特别重要的是预防血栓形成或出血并发症、处理相关的血小板减少症，以及在凝血时间延长的情况下进行围手术期抗凝监测的实验室方法。
