Cole C W, Fournier L M, Bormanis J
Department of Surgery, Ottawa Civic Hospital, Ont.
Can J Surg. 1990 Jun;33(3):207-10.
Heparin-associated thrombocytopenia and thrombosis (HATT) is an infrequent occurrence but may have disastrous consequences. Continued therapy with heparin must be avoided and anticoagulation achieved by alternative means. Among the few alternatives to heparin in critically ill patients, the best is ancrod. Depletion of fibrinogen with ancrod results in anticoagulation comparable to therapy with heparin within 12 hours. In a small series, nine patients with HATT were treated with ancrod; one underwent angiographic assessment, angioplasty and subsequent vascular reconstruction. Ancrod therapy was not associated with bleeding complications. It appears to provide optimal therapy for patients suspected of having HATT.
肝素相关性血小板减少症和血栓形成（HATT）虽不常见，但可能会产生灾难性后果。必须避免继续使用肝素治疗，应通过其他方法实现抗凝。在重症患者中，肝素的少数替代药物中，最好的是安克洛酶。使用安克洛酶消耗纤维蛋白原可在12小时内产生与肝素治疗相当的抗凝效果。在一个小样本系列中，9例HATT患者接受了安克洛酶治疗；1例接受了血管造影评估、血管成形术及随后的血管重建。安克洛酶治疗未出现出血并发症。它似乎为疑似患有HATT的患者提供了最佳治疗方法。
