风湿性心脏病合并免疫性血小板减少症患者的二尖瓣置换术。
Mitral valve replacement in patients of rheumatic heart disease associated with immune thrombocytopenia.
作者信息
Goyal Vikas Deep, Pahade Akhilesh, Misra Gaurav, Kaira Vaanika
机构信息
Department of Surgery, SRMS, IMS, Bareilly, UP 243202 India.
Department of Anaesthesia, SRMS, IMS, Bareilly, UP 243202 India.
出版信息
Indian J Thorac Cardiovasc Surg. 2023 Sep;39(5):516-521. doi: 10.1007/s12055-023-01517-4. Epub 2023 Jun 1.
Immune thrombocytopenia in association with rheumatic heart disease is not commonly seen. Surgical management of rheumatic heart disease becomes more challenging in the presence of immune thrombocytopenia. The risk of complications increases manifold and judicious medical management before, during, and after surgery is imperative. We discuss two such cases, the complications we faced and the problems we anticipated before, and their prevention. Both patients were managed without using immunoglobulins or doing splenectomy. The literature on valve replacement in patients of immune thrombocytopenia and the implications of immune thrombocytopenia in the management of patients with rheumatic heart disease is also reviewed.
免疫性血小板减少症合并风湿性心脏病并不常见。在存在免疫性血小板减少症的情况下，风湿性心脏病的外科治疗变得更具挑战性。并发症的风险会大幅增加，术前、术中和术后进行明智的药物管理至关重要。我们讨论两例这样的病例、我们所面临的并发症以及术前预期的问题及其预防措施。两名患者均未使用免疫球蛋白或进行脾切除术。本文还回顾了免疫性血小板减少症患者瓣膜置换的相关文献以及免疫性血小板减少症对风湿性心脏病患者管理的影响。
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