Diagnosis and treatment of rare anticoagulation complication thrombocytopenia induced by low-molecular-weight heparin after joint replacement
10.3760/cma.j.issn.1673-4904.2013.05.001
- VernacularTitle:关节置换术后低分子量肝素抗凝罕见合并症肝素诱导性血小板减少症的诊断与处理
- Author:
Lei ZHOU
;
Xisheng WENG
;
Jin JIN
;
Ning TANG
;
Wei WANG
;
Lin SHENG
;
Lijuan ZHAO
- Publication Type:Journal Article
- Keywords:
Heparin,low-molecular-weight;
Arthroplasty,replacement;
Diagnosis
- From:
Chinese Journal of Postgraduates of Medicine
2013;(5):1-4
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of anticoagulation complication,heparin-induced thrombocytopenia (HIT),induced by low-molecular-weight heparin (LMWH) after joint replacement.Methods Retrospectively analyzed the clinical manifestations,treatment and prognosis of 4 patients after total knee arthroplasty (TKA) suffered from HIT induced by LMWH.Results The morbidity rate of HIT induced by LMWH was 0.3％(4/1376).Platelets were found less than 70 × 109/L after 4-9 d,minimum to 16 × 109/L.Different level of cardiorespiratory distress and lower extremity deep venous thrombosis all appeared.Once diagnosed,patients were immediately stopped using LMWH and replaced with argatroban,fondaparinux or rivaroxaban and warfarin.Deep vein thrombosis gradually disappeared and cured in 3 patients after treatment.One patient suffered cerebral hemorrhage and multiple pulmonary embolism,received craniotomy hematoma removal and decompressive craniectomy.But the patient didn't wake up after 1-month treatment,became a vegetative one.Conclusions HIT is rare but dangerous,which can result in deep vein thrombosis,pulmonary embolism,cerebral hemorrhage and other serious consequences.Early diagnosis and timely treatment can reduce the rate of disability and mortality.
