Clinical analysis of rapid thrombocytopenia after percutaneous transcatheter closure of arteries in children

Q4 Medicine

中华实用儿科临床杂志 Pub Date : 2020-01-05 DOI:10.3760/CMA.J.ISSN.2095-428X.2020.01.014

Z. Ji, Na Liu, G. Luo, Zhen Bing

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引用次数: 0

Abstract

目的探讨经皮动脉导管介入封堵术后血小板快速减少的临床特点、发病机制和防治措施。方法选择2017年1月至2018年12月青岛市妇女儿童医院心脏中心共实施经皮动脉导管介入封堵手术121例，其中6例术后发生血小板快速减少，回顾分析其相关临床资料，总结血小板快速减少发生的危险因素、临床特点、可能机制和防治措施。结果 6例患儿血小板减少发生时间为术后第3－5天，血小板下降最低值为19×109/L，血小板恢复时间为术后7～20 d。造影测量动脉导管内径为4.0～4.5 mm，4例选用美国AGA公司生产规格9-PDA-0810堵闭器，2例选用上海形状记忆公司生产规格0810PDA堵闭器。骨髓学检查提示3例患儿骨髓产板型巨核细胞减少，免疫治疗后恢复良好。所有患儿血小板计数在出院时恢复正常。出院随访6～14个月，所有患儿血小板计数维持正常。结论经皮动脉导管介入封堵术后需警惕血小板快速减少，多无严重并发症发生，预后良好，免疫机制可能参与其中，需进一步研究。

查看原文本刊更多论文

儿童经皮动脉闭塞术后快速血小板减少的临床分析

Objective To explore the clinical characteristics, pathogenesis, and prevention and treatment measures of rapid platelet reduction after percutaneous arterial catheter occlusion. Method: From January 2017 to December 2018, the Heart Center of Qingdao Women and Children's Hospital conducted a total of 121 cases of percutaneous arterial catheter occlusion surgery. Among them, 6 cases experienced rapid thrombocytopenia after surgery. The relevant clinical data were retrospectively analyzed, and the risk factors, clinical characteristics, possible mechanisms, and prevention and treatment measures for rapid thrombocytopenia were summarized. The occurrence time of thrombocytopenia in 6 children was 3-5 days after surgery, and the lowest value of thrombocytopenia was 19 × 109/L, platelet recovery time is 7 to 20 days after surgery. The diameter of the arterial catheter measured by angiography was 4.0-4.5 mm. Four cases used the 9-PDA-0810 occluder produced by AGA Company in the United States, and two cases used the 0810 PDA occluder produced by Shanghai Shape Memory Company. Bone marrow examination showed a decrease in the production of plate type megakaryocytes in the bone marrow of 3 children, and they recovered well after immunotherapy. All pediatric platelet counts returned to normal upon discharge. During a follow-up period of 6-14 months after discharge, all patients maintained normal platelet counts. Conclusion: After percutaneous arterial catheter occlusion, it is necessary to be vigilant for rapid platelet reduction, with no serious complications, a good prognosis, and possible involvement of immune mechanisms. Further research is needed.

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来源期刊

中华实用儿科临床杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

14243

期刊介绍： Chinese Journal of Applied Clinical Pediatrics ( semi-monthly ) is a core journal of paediatrics under the supervision of China Association for Science and Technology, sponsored by Chinese Medical Association and undertaken by Xinxiang Medical College. Founded in 1986, it is openly circulated both at home and abroad. The journal has several columns, such as Expert Forum, Experimental Research and Paediatric Surgery, which are mainly for paediatric medical workers and medical researchers in hospitals. Its purpose is to reflect the new theories and technologies in paediatric medicine and scientific research at home and abroad, and to promote academic exchanges. Chinese Journal of Applied Clinical Pediatrics is a source journal of China Science Citation Database (CSCD), a core journal of Peking University, a source journal of Chinese science and technology paper statistics (China Science and Technology Core Journals), a core academic journal of RCCSE, a high-quality scientific and technical journal of China, a high-quality scientific and technical journal of China Association for Science and Technology, and a high-quality scientific and technical journal of China Biomedical Science and Technology Association. We have been published in China Biomedical Literature Database (SinoMed), China Knowledge Network, Wanfang Data Knowledge Service Platform, China Academic Journal Abstracts, Scopus Database, Chemical Abstracts (USA), Japan Science and Technology Agency (JSTA) Database, Copernicus Abstracts (Poland), Abstracts of the Centre for Agricultural and Biological Sciences (CABS) of the United Kingdom, Cambridge Scientific Abstracts ProQuest Database, WHO Medical Journal of the Western Pacific Region (WMPR), and WHO Medical Journal of the Western Pacific Region (WMPR) of the United States. We have been included in dozens of authoritative databases at home and abroad, such as WHO Western Pacific Region Index of Medicine (WPRIM), Ullrich's Guide to Periodicals, and so on.