Tani Makiko, Takahashi Yukio, Kobayashi Osamu, Nakamura Kyoichi, Oto Hirotaka
Division of Anesthesia, Kameda Medical Center, Kamogawa 296-0041.
Masui. 2007 Feb;56(2):196-9.
Coronary artery bypass graft surgery in patients with immune thrombocytopenic purpura (ITP) refractory to preoperative medical therapy accompanies an increased risk of bleeding perioperatively. In the ITP patient without responding to intravenous immunoglobulin and corticosteroids, we performed combined off-pump coronary artery bypass grafting with splenectomy to minimize the risk of intraoperative bleeding and cardiac ischemia. Using platelets infusion, we successfully managed the patient without major bleeding and ischemic events.
对于术前药物治疗无效的免疫性血小板减少性紫癜（ITP）患者，冠状动脉搭桥手术会增加围手术期出血风险。对于对静脉注射免疫球蛋白和皮质类固醇无反应的ITP患者，我们进行了非体外循环冠状动脉搭桥术联合脾切除术，以尽量降低术中出血和心脏缺血风险。通过输注血小板，我们成功治疗了该患者，未发生重大出血和缺血事件。
