Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan.
Department of Interventional Radiology, Japanese Red Cross Medical Center, Japan.
Intern Med. 2021 Nov 1;60(21):3503-3506. doi: 10.2169/internalmedicine.7422-21. Epub 2021 Aug 24.
In hospitalized coronavirus disease 2019 (COVID-19) patients, anticoagulation therapy is administered to prevent thrombosis. However, anticoagulation sometimes causes bleeding complications. We herein report two Japanese cases of severe COVID-19 in which spontaneous muscle hematomas (SMH) developed under therapeutic anticoagulation with unfractionated heparin. Although the activated partial prothrombin time was within the optimal range, contrast-enhanced computed tomography (CECT) revealed SMH in the bilateral iliopsoas muscles in both cases, which required emergent transcatheter embolization. Close monitoring of the coagulation system and the early diagnosis of bleeding complications through CECT are needed in severe COVID-19 patients treated with anticoagulants.
在住院的 2019 冠状病毒病（COVID-19）患者中，给予抗凝治疗以预防血栓形成。然而，抗凝有时会引起出血并发症。本文报告了两例日本 COVID-19 重症患者，在接受未分级肝素治疗性抗凝时发生自发性肌肉血肿（SMH）。尽管活化部分凝血活酶时间在最佳范围内，但增强计算机断层扫描（CECT）显示在这两例患者的双侧髂腰肌中均存在 SMH，需要紧急进行经导管栓塞治疗。在 COVID-19 重症患者中使用抗凝药物治疗时，需要密切监测凝血系统并通过 CECT 早期诊断出血并发症。
