Lv Fang-Fang, Li Mei-Ye, Qu Wei, Jiang Zhao-Shun
Department of Endocrinology, 960 Hospital of PLA, Jinan 250014, Shandong Province, China.
World J Clin Cases. 2023 Sep 16;11(26):6147-6153. doi: 10.12998/wjcc.v11.i26.6147.
Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis, and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice. But one uncommon side effect of low-molecular-weight heparin is heparin-induced thrombocytopenia (HIT), which can develop into thrombosis if not caught early or managed incorrectly.
We present a case of a patient who underwent hip arthroplasty and experienced thrombocytopenia due to HIT on the 9 d following the application of low-molecular-weight heparin anticoagulation. We did not diagnose HIT in time and applied 1 unit of platelets to the patient, which led to thrombosis. Luckily, the patient recovered following effective and timely surgery and treatment with rivaroxaban.
Patients using low-molecular-weight heparin after lower limb surgery need to have their platelet counts regularly checked. If HIT develops, platelet treatment should be given with caution.
下肢手术后的抗凝治疗是避免血栓形成的关键方法之一,低分子量肝素是临床实践中最常用的治疗药物。但低分子量肝素一种不常见的副作用是肝素诱导的血小板减少症(HIT),如果不及早发现或处理不当,可能会发展为血栓形成。
我们报告一例患者,该患者接受了髋关节置换术,在应用低分子量肝素抗凝治疗后第9天因HIT出现血小板减少症。我们未及时诊断出HIT,并给患者输注了1单位血小板,这导致了血栓形成。幸运的是,患者在接受了有效的及时手术及利伐沙班治疗后康复。
下肢手术后使用低分子量肝素的患者需要定期检查血小板计数。如果发生HIT,应谨慎给予血小板治疗。