作者：康世威，孙佳伟，宫小薇，袁雅冬

单位：

河北医科大学第二医院呼吸与危重症医学二科

Units：

Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, ChinaCorresponding author: YUAN Yadong, E-mail: yuanyd1108@163.com

关键词：

贫血,再生障碍性; 肺栓塞; 血小板减少; 抗凝治疗; 病例报告;

Keywords：

Anemia, aplastic; Pulmonary embolism; Thrombocytopenia; Anticoagulation therapy; Case reports

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.016

Funds：

河北省中医药管理局 2016 年度中医药类科研计划项目（2016045）

摘要：

肺血栓栓塞症是临床常见的危重症之一,规范、足量的抗凝治疗是溶解肺动脉血栓、改善患者症状、降低死亡风险的重要手段。而对于同时合并血小板减少的肺血栓栓塞症患者,查找病因并明确诊断、预防出血与抗凝治疗仍是诊治难点。本文报道1例以肺血栓栓塞症为首发表现的再生障碍性贫血患者的临床诊治经过,以期提高临床工作者对该类疾病的认识。分析表明,再生障碍性贫血患者发生静脉血栓栓塞症风险较高,综合平衡抗凝获益及其出血风险、强化医患沟通是做出合理临床决策及治疗成功的关键。

Abstract：

【Abstract】 Pulmonary thromboembolism is one of the common critical diseases in clinic. Standard and sufficientanticoagulant therapy is an important means to dissolve pulmonary artery thrombosis, improve patients' symptoms and reducethe risk of death. However, for patients with pulmonary thromboembolism complicated with thrombocytopenia at the same time, itis still difficult to find out the etiology and make clear diagnosis, prevent bleeding and anticoagulant therapy. This paper reportsthe clinical diagnosis and treatment of a aplastic anemia patient with pulmonary thromboembolism as the first manifestation, inorder to improve the understanding of this kind of disease among clinical workers. The result shows that patients with aplasticanemia have a high risk of venous thromboembolism. Comprehensive balance of anticoagulant benefits and bleeding risk, andstrengthening doctor-patient communication are the key to making reasonable clinical decisions and successful treatment.

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