以出血为首发症状的原发性血小板增多症10例临床诊治体会

Clinical experience of diagnosis and treatment of 10 cases of essential thrombocythemia with bleeding as initial symptom

目的探讨在临床工作中以出血为首发症状的原发性血小板增多症(ET)的临床表现及诊治体会。方法对我院2014年6月~2016年6月收治的10例主要以出血为首发症状的原发性血小板增多症患者的临床资料进行分析、总结,针对不同表现给予的不同治疗。结果 10例ET患者治疗后血小板均较入院时明显下降,波动范围(290~899)×10~9/L,2例消化道出血患者血红蛋白恢复正常,急性出血症状均得到控制。随访6个月时10例患者血小板先后恢复正常。结论原发性血小板增多症容易合并血栓已被人们普遍认识且发病率较高,而出血虽也是此病的临床表现之一,但发病率低且报道较少,尤其对于短期急性出血所致失血性休克的报道更为罕见,所以快速明确病因积极的救治对疾病的预后尤为重要。

Objective To explore the experiences of the clinical manifestation,diagnosis and treatment of essential thrombocythemia with bleeding as the initial symptom in clinical work.Methods Clinical data of 10 patients with essential thrombocythemia with bleeding as the initial symptom who were admitted to our hospital from June 2014 to June2016 were analyzed and summarized,and different treatments were given according to the different manifestations.Results The platelet count of the 10 patients with ET was significantly decreased compared with that upon admission,and the range of fluctuation was（290-899）×10^9/L.Hemoglobin was resumed to normal in 2 gastrointestinal bleeding patients,and acute bleeding symptoms were under control.At 6 months of follow-up,platelets were resumed to normal in 10 patients successively.Conclusion Essential thrombocythemia is easy to be complicated with thrombus,which have been recognized generally and the incidence is high.The bleeding is one of the clinical manifestations of the disease,but the incidence is low and less reported.The report about shock induced by short-term acute hemorrhagia is rarer particularly.Therefore,timely understanding the cause of disease and active treatment are particularly important for the prog-nosis.