原发性血小板减少性紫癜所致腹腔镜胆囊切除术后大出血原因及处理(附3例报告)  

The Causes and Management of Massive Bleeding after Laparoscopic Cholecystectomy with ITP

作　　者：张克兰[1] 魏尚典[2] 

机构地区：[1]中南大学湘雅医学院附一院,湖南长沙410008 [2]常德市第一人民医院

出　　处：《腹腔镜外科杂志》2005年第3期158-160,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨原发性血小板减少性紫癜(IdiopathicThrombocytopenicPurpura,ITP)所致腹腔镜胆囊切除(LC)术后大出血原因及处理。方法:对我院3例原患者临床资料进行回顾性分析。结果:大出血原因主要为:术前盲目相信“BT、CT正常”检验结果,术前及出血后未输注足量血小板,输注足量血小板仍出血时未及时想到混合因素所致。经输注足量血小板及输注新鲜血浆(必要时)后,3例患者均治愈。结论:对ITP患者实施LC,无论BT、CT是否正常,术前均应输注足量血小板,术中细致操作,大出血输注血小板无效时应及时想到混合因素所致出血并做出相应处理,是预防术后大出血的重要因素。Objective:To investigate the causes and management of massive bleeding after laparoscopic cholecystectomy with ITP.Methods:The clinical data of 3 patients with massive bleeding after laparoscopic cholecystectomy with ITP were analyzed retrospectively. Results:The main causes of postoperative massive bleeding were: misleading by the results of BT and CT; inadequate transfusion of platelet pre and postoperatively; neglecting of mixed hemorrhogic factors.However,all the 3 cases were cured by means of adequate transfusion of platelet and fresh plasma(if necessary).Conclusion:When performing LC in patients with ITP,adequate transfusion of platelet in advance regardless of the results of BT and CT;careful intraoperatiue disposal;timely analysis and handling of mixed hemorrhagic factors are vitally important to prevent postoperatine massive bleeding.

关 键 词：原发性血小板减少性紫癜 腹腔镜胆囊切除 术后大出血 原因及处理 回顾性分析 输注血小板 临床资料 出血原因 检验结果 新鲜血浆 患者实施 足量 术前 出血时 ITP BT CT 

分 类 号：R657.4[医药卫生—外科学]