Brennan M B, MacKean G L
Department of Surgery, Camp Hill Hospital, Halifax, NS.
Can J Surg. 1994 Apr;37(2):161-4.
Heparin used in the treatment of thromboembolic disease may produce an immune response in the patient, leading to thrombocytopenia and even thrombosis. These complications may arise at any time after the institution of heparin therapy. The authors report a case of heparin-induced thrombocytopenia with thrombosis in a 70-year-old woman. The complication was treated successfully with thrombectomy and the administration of warfarin and ancrod, which is a natural fibrinolytic agent. The nature of heparin-induced thrombosis and the mechanism of action of ancrod are discussed. The authors emphasize that all patients receiving heparin therapy should be closely monitored to detect hematologic disorders and to prevent their sequelae. Ancrod provides a reasonable therapeutic option if thrombosis does occur.
用于治疗血栓栓塞性疾病的肝素可能会在患者体内产生免疫反应,导致血小板减少甚至血栓形成。这些并发症可能在肝素治疗开始后的任何时间出现。作者报告了一例70岁女性发生肝素诱导的血小板减少伴血栓形成的病例。通过血栓切除术以及给予华法林和天然纤溶酶安克洛成功治疗了该并发症。文中讨论了肝素诱导的血栓形成的性质以及安克洛的作用机制。作者强调,所有接受肝素治疗的患者都应密切监测,以发现血液学紊乱并预防其后遗症。如果确实发生血栓形成,安克洛提供了一种合理的治疗选择。