一名特发性血小板减少性紫癜患者的二尖瓣置换术：术前用达那唑治疗。

Mitral valve replacement in a patient with idiopathic thrombocytopenic purpura: preoperative treatment with danazol.

作者信息

Richards K M, Ferraris V A

机构信息

Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, California.

出版信息

J Cardiovasc Surg (Torino). 1991 Nov-Dec;32(6):840-2.

PMID:1752909

Abstract

A 64-year-old woman with refractory idiopathic (autoimmune) thrombocytopenic purpura required urgent mitral valve replacement. Preoperative therapeutic interventions to raise dangerously low platelet counts were unsuccessful until danazol therapy was institued. Danazol therapy was associated with elevation of the platelet count to greater than 125 x 10(9)/L and allowed successful mitral valve replacement and left atrial thrombectomy to be performed. Postoperative bleeding was average and blood product replacement was not excessive. This case of mitral valve disease in a patient with idiopathic (autoimmune) thrombocytopenic purpura is unique, because perioperative hemostasis was accomplished using danazol and splenectomy was not required.

摘要

一名64岁患有难治性特发性（自身免疫性）血小板减少性紫癜的女性需要紧急进行二尖瓣置换术。在开始使用达那唑治疗之前，术前提高极低血小板计数的治疗干预均未成功。达那唑治疗使血小板计数升高至大于125×10⁹/L，并得以成功进行二尖瓣置换术和左心房血栓切除术。术后出血情况为平均水平，血液制品的输注量并不过多。该例特发性（自身免疫性）血小板减少性紫癜患者合并二尖瓣疾病的情况较为独特，因为围手术期通过使用达那唑实现了止血，且无需进行脾切除术。