第502例——血小板减少、巨脾、DIC、自发性脾破裂  

The 502nd case:thrombocytopenia,splenomegaly,disseminated intravascular coagulation,and spontaneous rupture of the spleen

作　　者：金相红 韩显林 贾丛伟 庄俊玲[1] 陈苗 Jin Xianghong;Han Xianlin;Jia Congwei;Zhuang Junling;Chen Miao(Department of Hematology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of General Surgery,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pathology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院血液内科,北京100730 [2]中国医学科学院、北京协和医学院、北京协和医院基本外科,北京100730 [3]中国医学科学院、北京协和医学院、北京协和医院病理科,北京100730

出　　处：《中华内科杂志》2023年第10期1249-1252,共4页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金(81970106);中央高水平医院临床科研业务费(2022-PUMCH-B-048)。

摘　　要：1例青年男性,既往血小板减少症7年余,本次因巨脾、发热起病,快速进展至弥散性血管内凝血(DIC)、失血性休克,考虑自发性脾破裂,急诊行脾切除术,组织病理学诊断为脾紫癜。脾紫癜罕见,病因及病理机制尚不明确。自发性脾破裂合并DIC死亡率极高,本例患者得以成功救治,本文分享诊治经过。A young man with a history of thrombocytopenia for seven years presented with splenomegaly and fever and rapidly evolved to disseminated intravascular coagulation(DIC)and hemorrhagic shock.Spontaneous rupture of the spleen was diagnosed.The critical patient underwent an emergency splenectomy.Pathological examination revealed splenic peliosis,an extremely rare disease with unknown etiology and pathogenesis.Despite the high mortality rate due to spontaneous splenic rupture with DIC,the patient was successfully treated and the details of the case are presented in this report.

关 键 词：脾大 脾破裂 弥漫性血管内凝血 脾紫癜 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R551.1[医药卫生—内科学]