Diamant D S
Madonna Rehabiliration Hospital, Lincoln, NE 68506, USA.
Arch Phys Med Rehabil. 1996 Oct;77(10):1090-2. doi: 10.1016/s0003-9993(96)90074-x.
A rare cause of limb amputation is heparin-associated thrombocytopenia with thrombosis (HATT). There have been no case reports in the rehabilitation literature of lower extremity amputation secondary to HATT. Three case reports are presented to illustrate how HATT can develop and cause limb ischemia with subsequent amputation. HATT occurs in less than 1% of patients receiving heparin, has an immunological basis for its etiology, and is diagnosed both clinically and with laboratory confirmation. In addition, there are various treatment options, with the most fundamental being cessation of heparin therapy. HATT does present in the rehabilitation setting and physiatrists should be prepared to diagnose and manage it effectively.
肢体截肢的一个罕见原因是肝素相关性血小板减少伴血栓形成（HATT）。康复文献中尚无HATT继发下肢截肢的病例报告。本文呈现三例病例报告，以说明HATT如何发展并导致肢体缺血继而截肢。接受肝素治疗的患者中，HATT的发生率低于1%，其病因具有免疫基础，可通过临床及实验室检查确诊。此外，有多种治疗选择，最根本的是停止肝素治疗。HATT确实会出现在康复环境中，物理治疗师应做好有效诊断和管理的准备。
