Tanita T, Nishimura T, Kubo H, Handa M, Okada Y, Hoshikawa Y, Ueda S, Shibuya J, Iwabuchi S, Ashino Y
Department of Surgery, Tohoku University, Sendai, Japan.
Kyobu Geka. 1994 Apr;47(4):328-31.
A 61-year-old patient was admitted to our hospital because of a chest abnormal shadow. He was suffered from ocular myopathy for more than 4 years. A lab data on the admission showed only a slight thrombocytopenia. After the unilateral pulmonary arterial occlusion test for the preoperative evaluation of thoracotomy, the hemorrhagic tendency was appeared. A detailed examination proved idiopathic thrombocytopenic purpura which was presumed to be caused by the heart catheterization. We employed high-dose intravenous gamma-globulin infusion and concentrated platelet transfusion for 5 days for preventing hemorrhagic complications during the thoracotomy. The partial resection was undergone for the left upper lobe tumor, which was proved as large cell carcinoma. The postoperative hemorrhage was well controlled. We conclude that the high-dose intravenous gamma-globulin infusion and/or concentrated platelets transfusion should be positively employed for the patients with even slight thrombocytopenic purpura.
一名61岁患者因胸部异常阴影入住我院。他患有眼肌病4年多。入院时实验室检查仅显示轻度血小板减少。在进行开胸术前评估的单侧肺动脉闭塞试验后，出现了出血倾向。详细检查证实为特发性血小板减少性紫癜，推测是由心脏导管插入术引起的。我们采用大剂量静脉注射丙种球蛋白输注和浓缩血小板输注5天，以预防开胸术中的出血并发症。对左上叶肿瘤进行了部分切除，病理证实为大细胞癌。术后出血得到了很好的控制。我们得出结论，对于即使有轻度血小板减少性紫癜的患者，也应积极采用大剂量静脉注射丙种球蛋白输注和/或浓缩血小板输注。
