特发性血小板减少性紫癜患者急诊行阑尾切除术的围手术期成功管理：病例报告
Successful perioperative management of a patient with idiopathic thrombocytopenic purpura undergoing emergent appendectomy: Report of a case.
作者信息
Toyomasu Yoshitaka, Shimabukuro Rinshun, Moriyama Hatsuo, Eguchi Daihiko, Ishikawa Koichi, Kishihara Fumiaki, Fukuyama Yasurou, Matsumata Takashi, Mochiki Erito, Kuwano Hiroyuki
机构信息
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; Department of Surgery, Nakatsu Municipal Hospital, 173 Shimoikenaga, Nakatsu, Oita 871-8511, Japan.
出版信息
Int J Surg Case Rep. 2013;4(10):898-900. doi: 10.1016/j.ijscr.2013.05.019. Epub 2013 Aug 6.
INTRODUCTION
Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelet count and normal bone marrow. Patients with ITP undergoing surgery are thought to have increased risk for postoperative complications because of their thrombocytopenia.
PRESENTATION OF CASE
we report the case of a 66-year-old woman with ITP who required an emergency operation for acute appendicitis associated with disseminated intravascular coagulation. Preoperative therapy consisted of platelet transfusions only, and intraoperative hemostasis was achieved. Postoperatively, high-dose intravenous immunoglobulin (IVIg) therapy led to an increased, stable, and adequate platelet count and good hemostasis.
DISCUSSION
The outcome of this case suggests that IVIg therapy is not always required for preoperative management of patients with.
CONCLUSION
IVIg therapy may be useful for postoperative management after emergency surgery.
引言
特发性血小板减少性紫癜（ITP）是一种自身免疫性疾病，其特征为血小板计数低且骨髓正常。因血小板减少，接受手术的ITP患者被认为术后并发症风险增加。
病例介绍
我们报告一例66岁患有ITP的女性患者，该患者因急性阑尾炎合并弥散性血管内凝血而需要进行急诊手术。术前治疗仅包括输注血小板，术中实现了止血。术后，大剂量静脉注射免疫球蛋白（IVIg）治疗使血小板计数升高、稳定且充足，并实现了良好的止血效果。
讨论
该病例的结果表明，对于此类患者的术前管理并非总是需要IVIg治疗。
结论
IVIg治疗可能对急诊手术后的术后管理有用。
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