一名接受华法林治疗的患者发生大量自发性结膜下出血：病例报告。
Massive spontaneous subconjunctival hemorrhage in a patient on therapeutic warfarin: A case report.
作者信息
Philip Andrew M, Fry Matthew V, Hermanson Meghan E, Kelly Lisa D
机构信息
College of Medicine, University of Cincinnati, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
Department of Ophthalmology, University of Cincinnati, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
出版信息
Am J Ophthalmol Case Rep. 2021 Feb 26;22:101049. doi: 10.1016/j.ajoc.2021.101049. eCollection 2021 Jun.
PURPOSE
To describe a case of massive spontaneous subconjunctival hemorrhage in a patient taking warfarin with a therapeutic international normalized ratio (INR).
OBSERVATIONS
Massive circumferential hemorrhagic chemosis, extensive periorbital and facial ecchymosis, and active arterial extravasation in the subconjunctiva which required cessation and reversal of anticoagulation. Findings gradually resolved over several months after discharge.
CONCLUSIONS AND IMPORTANCE
While subconjunctival hemorrhage, even in anticoagulated patients, is usually benign, rare examples of severe presentations exist. We present, to our knowledge, the first documented case of a subconjunctival hemorrhage necessitating cessation and reversal of anticoagulation in the setting of a therapeutic INR.
目的
描述一例正在服用华法林且国际标准化比值（INR）处于治疗范围的患者发生大量自发性结膜下出血的病例。
观察结果
结膜广泛环形出血性水肿、眶周及面部广泛瘀斑，结膜下有活动性动脉性渗血，这需要停用抗凝药并进行抗凝逆转。出院后数月，这些表现逐渐消退。
结论及重要性
虽然结膜下出血即使在抗凝患者中通常也是良性的，但仍存在严重表现的罕见病例。据我们所知，我们报告了首例在INR处于治疗范围的情况下因结膜下出血而需要停用抗凝药并进行抗凝逆转的病例。
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