Kapsch D, Silver D
Arch Surg. 1981 Nov;116(11):1423-7. doi: 10.1001/archsurg.1981.01380230047007.
Thrombocytopenia (platelet count, 5,000 to 96,000/cu mm; average platelet count, 48,000/cu mm) developed in 31 patients while they were receiving prophylactic or therapeutic heparin sodium therapy. Twenty-one of these patients had associated thromboembolic complications that contributed to the deaths of eight patients. Twelve arterial thromboembolectomies were required for limb preservation in eight patients, with seven arterial thrombolectomies, early in the series, failing because heparin therapy was continued in the postoperative period. Coagulation tests failed to identify a consumptive coagulopathy as the cause of the thrombocytopenia. Cessation of heparin administration was associated with avoidance or remission of the thromboembolic complication and immediate improvement of the thrombocytopenia. Platelet count monitoring during heparin therapy remains the most effective means for the identification of this disorder before the development of the thromboembolic complications.
31例患者在接受预防性或治疗性肝素钠治疗时出现血小板减少（血小板计数为5,000至96,000/立方毫米；平均血小板计数为48,000/立方毫米）。其中21例患者伴有血栓栓塞并发症，导致8例患者死亡。为保全肢体，8例患者需要进行12次动脉血栓切除术，在该系列治疗初期，7次动脉血栓切除术失败，原因是术后继续进行肝素治疗。凝血试验未能确定消耗性凝血病是血小板减少的原因。停用肝素与避免或缓解血栓栓塞并发症以及血小板减少症立即改善有关。在肝素治疗期间监测血小板计数仍然是在血栓栓塞并发症发生之前识别这种疾病的最有效方法。
