Best Irwin M
Emory University School of Medicine, Department of Radiology, Interventional Radiology, Atlanta, GA, USA.
Clin Pract. 2011 Dec 1;1(4):e126. doi: 10.4081/cp.2011.e126. eCollection 2011 Sep 28.
When the platelet count falls below 20×10(9)/L, the risk of spontaneous life threatening hemorrhage is concerning for both physician and patient. When medical management fails, splenectomy is often used to manage the severe thrombocytopenia before spontaneous, life-threatening gastrointestinal or intracranial bleeding occurs. We present the non surgical management of such a patient with refractory sever thrombocytopenia who refused surgical intervention. She underwent partial splenic embolic therapy with 500-700μ particles. Her platelet count spontaneous recovered from less than 20×10(9)/L to normal range. Her counts remained in normal range after discharge home. Further study is needed to determine the most appropriate role for embolization in patients who are refractory to medical management and those with chronically low platelet counts requiring frequent plate transfusions for invasive procedures.
当血小板计数降至20×10⁹/L以下时，医生和患者都担心有发生危及生命的自发性出血风险。当药物治疗无效时，常在自发性、危及生命的胃肠道或颅内出血发生前，采用脾切除术来治疗严重血小板减少症。我们介绍了一位难治性严重血小板减少症患者拒绝手术干预后的非手术治疗情况。她接受了用500 - 700μ颗粒进行的部分脾栓塞治疗。她的血小板计数自发地从低于20×10⁹/L恢复到正常范围。出院回家后其计数仍保持在正常范围内。对于药物治疗无效以及血小板计数长期偏低、进行侵入性操作需要频繁输注血小板的患者，需要进一步研究以确定栓塞治疗的最合适作用。
