Ohura H, Sagawa M, Yoshida H, Kondo T, Matsumura Y, Saito R, Okada Y, Okaniwa G, Fujimura S
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Kyobu Geka. 1996 Jun;49(6):484-6.
A 71-year-old male was admitted to our hospital because of a chest abnormal shadow. His chest X-ray film showed a mass in the right lower lobe (S6), which was diagnosed as adenocarcinoma by transbronchial lung biopsy. A lab data on the admission showed thrombocytopenia (44,000 per cu. mm), and the results of the bone marrow aspiration was compatible with idiopathic thrombocytopenic purpura. Immediately after the right lower lobectomy with lymphnode dissection, intrathoracic bleeding from the wound due to hemorrhagic tendency appeared necessitating a re-thoracotomy. High-dose intravenous gamma-globulin infusion for 4 days and the frequent concentrated platelet transfusion were employed to prevent the hemorrhagic tendency after the 2nd operation, and the postoperative hemorrhage was successfully controlled. Perioperative high-dose intravenous gamma-globulin infusion was concluded to be useful in the patient of idiopathic thrombocytopenic purpura for preventing hemorrhagic tendency after the operation.
一名71岁男性因胸部异常阴影入住我院。他的胸部X光片显示右下叶（S6）有一个肿块，经支气管肺活检诊断为腺癌。入院时实验室检查显示血小板减少（每立方毫米44,000），骨髓穿刺结果符合特发性血小板减少性紫癜。在右下叶切除并清扫淋巴结后，由于出血倾向，伤口出现胸腔内出血，需要再次开胸手术。术后采用大剂量静脉注射丙种球蛋白4天，并频繁输注浓缩血小板以预防出血倾向，术后出血得到成功控制。得出结论，围手术期大剂量静脉注射丙种球蛋白对特发性血小板减少性紫癜患者预防术后出血倾向是有用的。
