Hayashi S, Eguchi Y, Satou K
Department of Cardiovascular Surgery, Chugoku Rosai General Hospital, Kure, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Nov;44(11):2091-4.
The patient was a 76-year-old woman with angina, and diagnosed as idiopathic thrombocytopenic purpura (ITP) by preoperative blood examination. High-dose transvenous gamma-globulin (0.3 g/kg/day) therapy was subsequently conducted for 4 days before operation. Platelet count increased from 5.3 x 10(4)/mm3 to 19.9 x 10(4)/mm3, and thus coronary artery bypass grafting (CABG) was carried out using bilateral internal thoracic arteries and the right gastroepiploic artery. 20 and 10 units platelet-rich fluid were administered by transfusion on the day of the operation and the second day thereafter. Postoperative bleeding quantity was slightly more than usual. All grafts were patent and the postoperative course was satisfactory. Arterial grafts may thus be considered suitable for CABG in patients with ITP.
该患者为一名76岁的心绞痛女性，术前血液检查诊断为特发性血小板减少性紫癜（ITP）。术前随后进行了4天高剂量静脉注射丙种球蛋白（0.3 g/kg/天）治疗。血小板计数从5.3×10⁴/mm³增至19.9×10⁴/mm³，因此使用双侧胸廓内动脉和右胃网膜动脉进行了冠状动脉旁路移植术（CABG）。手术当天及术后第二天通过输血分别输注了20单位和10单位富含血小板的液体。术后出血量略多于平常。所有移植物均通畅，术后病程满意。因此，对于ITP患者，动脉移植物可被认为适用于CABG。
