原发免疫性血小板减少症并发围术期深静脉血栓1例并文献复习及思考

Primary immune thrombocytopenia complicated with perioperative deep venous thrombosis:a case report and literature review

目的探讨围术期合并原发免疫性血小板减少症(ITP)病例预防出血及血栓形成的临床应对方案。方法回顾性分析1例ITP患者并发围术期深静脉血栓的临床资料,并汇总复习相关文献资料。结果ITP患者不仅需关注血小板减少相关出血风险,也应当关注发生血栓事件风险。手术及升血小板治疗均有可能是ITP患者血栓发生的危险因素。围术期建议常规监测血常规、凝血功能及血管超声检查,适时停用升血小板药物,必要时需抗凝治疗,以预防及早期发现深静脉血栓。结论围术期的ITP患者需警惕血栓发生风险。

Objective To explore the clinical scheme in prevention of bleeding and thrombosis in perioperative patients with primary immune thrombocytopenia(ITP).Methods The clinical data of a patient with ITP and deep venous thrombosis during perioperative period were analyzed retrospectively,and the relevant literatures were summarized and reviewed.Results ITP patients should pay attention not only to the risk of thrombocytopenia related bleeding,but also to the risk of thrombotic events.Surgery and platelet raising therapy may be the risk factors of thrombosis in patients with ITP.During the perioperative period,it is recommended to routinely monitor blood routine,coagulation function,and vascular ultrasound,stop platelet raising drugs in time,and take anticoagulant treatment if it is necessary,so as to prevent and early detect deep venous thrombosis.Conclusion Patients with ITP should be alert to the risk of thrombosis during perioperative period.