Barna László, Gyenes István, Kiss Levente, Csapó Kálmán
Borsod-Abaúj-Zemplén Megyei Kórház I. Belgyógyászat-Kardiológia Miskolc.
Orv Hetil. 2010 Jul 11;151(28):1145-8. doi: 10.1556/OH.2010.28878.
The haematoma in the sheath of musculus rectus abdominis is a rare clinical entity. Its diagnosis is often difficult. Authors observed it in three patients who were on anticoagulant therapy. All subjects were female; two of them had decreased renal function. All three patients received thrombocyte aggregation inhibitor therapy as well. The anticoagulant treatment (low molecular weight heparin in two cases, warfarin in one case) caused excessive anticoagulant effect. The diagnosis, which could be suspected after the physical examination, was established in two cases by ultrasonography and in one case by computed tomography. Two patients were surgically treated while the third patient was healed with conservative treatment. To prevent the rectus sheath haematoma, authors suggest a particularly careful control of anticoagulant treatment in older females and in subjects with decreased renal function, especially if the patient takes thrombocyte aggregation inhibitors, too.
腹直肌鞘血肿是一种罕见的临床病症。其诊断往往困难。作者在三名接受抗凝治疗的患者中观察到了这种情况。所有受试者均为女性；其中两名肾功能减退。三名患者还接受了血小板聚集抑制剂治疗。抗凝治疗（两例使用低分子量肝素，一例使用华法林）导致抗凝作用过度。体格检查后可怀疑诊断，两例通过超声检查确诊，一例通过计算机断层扫描确诊。两名患者接受了手术治疗，而第三名患者通过保守治疗痊愈。为预防腹直肌鞘血肿，作者建议对老年女性和肾功能减退的患者，尤其是同时服用血小板聚集抑制剂的患者，应特别仔细地控制抗凝治疗。
