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血小板减少症:对缺血性和出血性卒中的影响。

Thrombocytopenia: Effect in Ischemic and Hemorrhagic Stroke.

出版信息

Dimens Crit Care Nurs. 2021;40(3):139-148. doi: 10.1097/DCC.0000000000000471.

Abstract

BACKGROUND

There are 2 classification of strokes: ischemic, if caused by an arterial occlusion from a clot or obstruction by atherosclerosis, and hemorrhagic, if caused by the rupture of a vessel and subsequent bleeding. Each type of stroke is influenced by platelet counts and platelet function. The intention of this article is to discuss the role of the platelet in the pathophysiology of acute stroke processes. This serves as a prelude to discussing these processes as disrupted with thrombocytopenia (low platelet counts). Platelets initiate clot formation and obstruct blood flow through the creation of a platelet plug. They also extend the penumbra in ischemic and hemorrhagic strokes. Thrombocytopenia can be a causal factor in an ischemic stroke, a risk factor for hemorrhagic stroke, and a risk factor for hemorrhagic stroke conversion.

METHODS

The aims of this study were to review 1 case study that illustrates the pivotal role of the platelet in strokes and to review the aspect that was impacted by autoimmune thrombocytopenia.

DISCUSSION

Thrombocytopenia is a hematologic disorder not often included in stroke care discussions. Thrombocytopenia sets up strokes to occur and, paradoxically, may also set the patient up for bleeding complications in the brain or groin.

CONCLUSION

Acknowledging the impact of both platelet and thrombocytopenia on stroke causation, stroke interventions, and outcomes is a pivotal aspect of comprehensive stroke care. Platelet function processes are impactful in each point of the continuum of stroke care, prevention, intervention, and discharge.

摘要

背景

中风有两种类型:缺血性,如果是由血栓引起的动脉阻塞或动脉粥样硬化引起的阻塞引起的;出血性,如果是由血管破裂和随后的出血引起的。每种类型的中风都受到血小板计数和血小板功能的影响。本文的目的是讨论血小板在急性中风过程中的病理生理学中的作用。这是讨论血小板减少症(血小板计数低)引起这些过程中断的前奏。血小板通过形成血小板栓来启动血栓形成并阻塞血流。它们还会扩大缺血性和出血性中风的半影区。血小板减少症可能是缺血性中风的一个因果因素,是出血性中风的一个危险因素,也是出血性中风转化的一个危险因素。

方法

本研究的目的是回顾一个病例研究,该研究说明了血小板在中风中的关键作用,并回顾了自身免疫性血小板减少症所影响的方面。

讨论

血小板减少症是一种血液疾病,在中风护理讨论中并不常被提及。血小板减少症会导致中风的发生,而且矛盾的是,它也可能使患者在大脑或腹股沟出现出血并发症的风险增加。

结论

承认血小板和血小板减少症对中风病因、中风干预和结果的影响是全面中风护理的关键方面。血小板功能过程在中风护理、预防、干预和出院的连续体的每一个点都有影响。

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