Samama M, Kher A, Horellou M H, Conard J, James J M, Zittoun R
J Mal Vasc. 1982;7(3):237-42.
Following operation for bladder papilloma and subcutaneous heparin therapy, a patient developed severe thrombopenia with biological signs of disseminated intravascular coagulation (D. I. C.). Heparin therapy was discontinued and the platelet count became normal, no further signs of (D. I. C.) being apparent. Histological examination of the excised tumor showed that it was non-malignant, the thrombopenia being directly related to the heparin treatment. A review of the published literature demonstrated variations in the frequency of this complication reported, with an apparently higher incidence in the USA than in France. This could possibly depend upon whether the heparin was prepared from pulmonary or intestinal tissue. The thrombopenia may be severe (platelet count less than 100,000/mm3) with resulting hemorrhages or more commonly thromboses, or moderate without clinical expression. The dose or mode of administration of the heparin does not appear to be a factor in the development of the thrombopenia, its mechanism not being clearly elucidated. From the practical point of view, a platelet count should be performed before heparin treatment, and this should be repeated if the treatment is continued for more than four days.
在膀胱乳头状瘤手术后接受皮下肝素治疗时，一名患者出现严重血小板减少症，并伴有弥散性血管内凝血（D.I.C.）的生物学体征。肝素治疗中断后，血小板计数恢复正常，且未再出现明显的弥散性血管内凝血迹象。对切除肿瘤的组织学检查显示其为非恶性，血小板减少症与肝素治疗直接相关。对已发表文献的回顾表明，所报道的这种并发症的发生率存在差异，美国的发病率明显高于法国。这可能取决于肝素是由肺组织还是肠组织制备而成。血小板减少症可能很严重（血小板计数低于100,000/mm³），导致出血，或者更常见的是血栓形成，也可能为中度且无临床表现。肝素的剂量或给药方式似乎不是血小板减少症发生的因素，其机制尚未完全阐明。从实际角度来看，在肝素治疗前应进行血小板计数，如果治疗持续超过四天，则应重复检查。
