4例复杂先天性心脏病术后并发肝素诱导的血小板减少症患者的监测

Monitoring of 4 patients with heparin-induced thrombocytopenia after complex congenital heart surgery

2013年7月至2015年2月中南大学湘雅医院心脏大血管外科收治的复杂先心病接受心脏直视手术的患者中有4例先后出现肝素诱导的血小板减少症(heparin-induced thrombocytopenia,HIT),通过严密动态监测血小板计数,观察HIT所致的栓塞性皮肤损伤情况,监测阿加曲班用药效果等综合治疗,3例痊愈,1例死亡。HIT是接受肝素治疗出现的罕见的严重并发症,栓塞发生率和病死率较高。早期识别、早期诊断高风险人群可以有效改善预后。

From July 2013 to February 2015,4 infant patients with complex congenital heart disease,who underwent open heart surgery in Xiangya Hospital of Central South University,were diagnosed as heparin-induced thrombocytopenia(HIT).After comprehensive treatments,such as intensive monitoring of the platelet count,close observation of thromboembolic skin lesions and close monitoring of argatroban therapy,3 patients were cured and 1 died.HIT is rare but serious in patients who received heparin therapy.The incidence of mortality and thrombosis is very high.Early identification and diagnosis of high-risk groups can improve the prognosis.