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A surgical case of aortic valve replacement in patient with chronic idiopathic thrombocytopenic purpura

机译:慢性特发性血小板减少性紫癜患者主动脉瓣置换术的外科病例

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摘要

A 64-year-old man was presented to another hospital with bleeding from the upper jaw with a platelet count of 0.1 x 10(4)/microl one year ago, and idiopathic thrombocytopenic purpura complicated with aortic stenosis and regurgitation was diagnosed. Corticosteroid administration was initiated and the patient was admitted to our hospital for surgery two months after confirmation of symptoms associated with cerebral ischemia. Corticosteroid was administered for one year until the day of surgery, and aortic valve replacement was performed with a platelet count of 8.4 x 10(4)/microl. During surgery, bleeding tendency with decreased platelets was confirmed, which was corrected with intraoperative platelet transfusion, postoperative gamma-globulin administration, and postoperative oral corticosteroid administration. Caution must be exercised against perioperative bleeding tendency in open heart surgery, even when platelet count is maintained using small amounts of preoperative corticosteroid.
机译:一名64岁的男子在一年前被送往另一家医院,因其上颌出血而血小板计数为0.1 x 10(4)/ microl,并诊断出特发性血小板减少性紫癜并发主动脉狭窄和反流。在确认与脑缺血有关的症状两个月后,开始使用皮质类固醇激素治疗,并将患者送入我院手术。给予皮质类固醇一年直至手术当天,并以8.4 x 10(4)/ microl的血小板计数进行主动脉瓣置换。在手术期间,证实了出血趋势和血小板减少,并在术中输注血小板,术后给予γ-球蛋白和术后口服皮质类固醇予以纠正。即使在术前少量使用皮质类固醇维持血小板计数的情况下,也必须注意避免心脏直视手术中围手术期出血的趋势。

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