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[肝素诱导的血小板减少症与腔静脉滤器。治疗难点]

[Heparin-induced thrombocytopenia and vena cava filter. Difficulties of treatment].

作者信息

Jouanny P, Jeandel C, Laurain M C, Penin F, Cuny G

机构信息

Service de Médecine Interne B, Hôpital de Brabois, CHU Nancy, Vandoeuvre.

出版信息

J Mal Vasc. 1993;18(4):320-2.

PMID:8120465
Abstract

The authors report two cases of thrombosis occurring after partial interruption of the inferior vena cava. They presented as collapse and anuria with fatal outcome. Heparin induced thrombocytopenia was present in two cases and distal migration of filter in one case. Thrombo-embolic complications can follow heparin induced thrombocytopenia and justify first treatment with low molecular weight heparin and/or early treatment with oral anti-coagulant. Thrombosis, recurrent embolism or thrombosis of renal vena may occur after vena cava filter. Renal vena thrombosis especially follow filter movement and present as collapse and cardiac failure often with fatal outcome.

摘要

作者报告了两例下腔静脉部分阻断后发生血栓形成的病例。患者表现为虚脱和无尿,最终死亡。两例均出现肝素诱导的血小板减少症,一例出现滤器远端移位。血栓栓塞并发症可继发于肝素诱导的血小板减少症,这证明首先使用低分子量肝素治疗和/或早期使用口服抗凝剂治疗是合理的。腔静脉滤器置入后可能发生血栓形成、复发性栓塞或肾静脉血栓形成。肾静脉血栓形成尤其继发于滤器移位,表现为虚脱和心力衰竭,常导致死亡。

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