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一种用于心脏手术期间肝素诱导的血小板减少症患者管理的新方法。

A novel method for the management of patients with heparin-induced thrombocytopaenia during cardiac surgery.

作者信息

Mishra Pankaj Kumar, Chnaris Asterinos, Mohammed Fayaz, Luckraz Heyman

机构信息

Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton , UK

Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton , UK.

出版信息

Interact Cardiovasc Thorac Surg. 2014 Jun;18(6):850-2. doi: 10.1093/icvts/ivu030. Epub 2014 Mar 6.

Abstract

A 63-year old, male patient presented with prosthetic valve endocarditis and developed heparin-induced thrombocytopaenia (HIT) following heparin administration for continuous veno-venous haemofiltration. Use of cardiopulmonary bypass in patients suffering from heparin-induced thrombocytopaenia is difficult and challenging. We report a novel method that allows heparin use in patients diagnosed with HIT using Multiplate platelet analyser and iloprost. Platelet function analysis is complex, poorly standardized and time consuming. Multiplate platelet analyser represents a convenient, safe, reliable and rapid system that allows the assessment of platelet dysfunction. It allows objective demonstration of platelet inhibition before administration of heparin, allowing safe establishment of cardiopulmonary bypass in patients suffering from HIT.

摘要

一名63岁男性患者因人工瓣膜心内膜炎就诊,在接受持续静脉-静脉血液滤过并使用肝素后发生肝素诱导的血小板减少症(HIT)。对于患有肝素诱导的血小板减少症的患者,使用体外循环困难且具有挑战性。我们报告了一种新方法,该方法允许在使用多电极血小板分析仪和伊洛前列素诊断为HIT的患者中使用肝素。血小板功能分析复杂、标准化程度低且耗时。多电极血小板分析仪是一种方便、安全、可靠且快速的系统,可用于评估血小板功能障碍。它能够在给予肝素前客观地证明血小板受到抑制,从而使患有HIT的患者能够安全地建立体外循环。

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