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利伐沙班用于治疗人工髋关节置换术患者肝素诱导的血小板减少症伴血栓形成:一例报告。

Rivaroxaban for the treatment of heparin-induced thrombocytopenia with thrombosis in a patient undergoing artificial hip arthroplasty: A case report.

作者信息

Lv Fang-Fang, Li Mei-Ye, Qu Wei, Jiang Zhao-Shun

机构信息

Department of Endocrinology, 960 Hospital of PLA, Jinan 250014, Shandong Province, China.

出版信息

World J Clin Cases. 2023 Sep 16;11(26):6147-6153. doi: 10.12998/wjcc.v11.i26.6147.

Abstract

BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

摘要

背景

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。

病例摘要

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfbc/10507566/94d49d83a2c5/WJCC-11-6147-g001.jpg

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