Stanton P E, Evans J R, Lefemine A A, Vo N M, Rannick G A, Morgan C V, Hinton P J, Read M
Department of Surgery, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City 37614.
South Med J. 1988 May;81(5):616-20. doi: 10.1097/00007611-198805000-00018.
Heparin therapy is currently a vital component in the medical management of thromboembolic events. Despite its widespread use, it is associated with relatively few complications, and these are usually minor and quickly reversible. Recently a much more dramatic and serious complication of heparin therapy has been identified. In heparin-induced thrombocytopenia with associated thrombosis or "white clot syndrome," patients have paradoxic thromboembolic events while receiving heparin. These events are of acute onset and of major consequence, often resulting in limb loss or death. This paper describes our own experience with ten patients in whom the white clot syndrome occurred during heparin therapy for thrombotic or embolic events. Both porcine and bovine heparin preparations were being given through various routes. In the three cases in which platelet aggregation testing was completed, results were positive. Our ten patients ultimately had a 20% major limb amputation rate and an overall 50% mortality.
肝素疗法目前是血栓栓塞事件医学管理中的重要组成部分。尽管其广泛应用，但与之相关的并发症相对较少，且通常较轻微且可迅速逆转。最近，已发现肝素疗法一种更为严重的并发症。在肝素诱导的血小板减少症伴相关血栓形成或“白色血栓综合征”中，患者在接受肝素治疗时会出现反常的血栓栓塞事件。这些事件起病急且后果严重，常导致肢体丧失或死亡。本文描述了我们对10例在肝素治疗血栓形成或栓塞事件期间发生白色血栓综合征患者的治疗经验。猪和牛的肝素制剂均通过多种途径给药。在完成血小板聚集试验的3例病例中，结果呈阳性。我们的10例患者最终主要肢体截肢率为20%，总体死亡率为50%。
