OVERVIEW
OVERVIEW
Heparin-induced thrombocytopenic purpura is a condition in which heparin treatment results in alterations to the platelet surface, which prompts antibodies to bind to platelet antigens, and antigen-antibody complexes to bind to the platelet’s Fc receptor, which in turn leads to thrombocytopenia. The disease can be categorized into type I and type II.
Whether medical insurance
Yes, it is
Department
Hematology
Clinical symptoms
Mild patients may show only thrombocytopenia, while severe patients may show thrombotic manifestations in addition to thrombocytopenia: local tissue ischemia, respiratory distress, skin necrosis, and abdominal pain.
Hazards
It may involve the heart, kidneys and other organs, affecting normal blood circulation.
Complications
Hypotension, thrombosis, etc.
Tests
Blood routine, heparin-dependent antibody test, 5-hydroxytryptamine is method, heparin-induced platelet aggregation test, etc.
Diagnosis
Diagnosis based on history of heparin therapy, decreased platelet count, etc.
Treatment principle
Reduce or discontinue heparin and give antithrombotic and other medications.
Curability
Most recover after discontinuation of heparin, some may have a poorer prognosis.
Dietary advice
Give high protein, vitamin-rich, low-fat foods.
Etiology
Etiology
Caused by the use of various doses of heparin.
Symptoms and Diagnosis
Typical symptoms
Thrombocytopenia in blood routine, arterial and venous thrombosis may occur, which is manifested by abdominal pain, swelling at the end of the limbs, localized tissue ischemia or necrosis, respiratory distress, and cardiac arrest.
Other symptoms
Bilateral adrenal hemorrhage and necrosis sometimes occur, resulting in severe hypotension.
Diagnostic basis
In patients who have received heparin therapy for 5 to 14 days without any other etiologic factors, if the platelet count is less than 100×109/L for 2 consecutive days, the disease can be considered; for difficult cases, the platelet count can be checked 6 to 12 hours after stopping the therapy, and the diagnosis can be made if the platelet count begins to rise and heparin-dependent antibodies are present.
Treatment
Treatment guidelines
Thrombocytopenia can be controlled by reducing or discontinuing heparin and giving antithrombotic drugs.
Drug therapy
1. If the platelet count is more than 50×109/L, stopping heparin should be done with caution because some patients’ platelets can return to normal on their own, and stopping heparin will aggravate the symptoms of thrombosis or recurrence; if the platelet count is less than 50×109/L, stopping heparin should be done immediately, and the platelet count will return to normal within a few days of stopping heparin, and the platelet count will begin to rise within a few hours of stopping heparin. 2. type I In addition to the above treatment, patients with type II should be treated with active antithrombotic therapy, which may include low molecular weight heparin and heparin-like drugs, combined with vitamin K antagonists or fibrinolytic drugs.
Prognosis
The prognosis of patients with type I is generally good; 20% of patients with type II need amputation, and the mortality rate is about 30%.
Nursing care
Daily care
1. strictly follow the doctor’s instructions for medication, do not increase or decrease the amount of medication or stop taking medication without authorization. 2. pay attention to rest, avoiding fatigue or trauma. 3. appropriate physical exercise, in order not to feel fatigue. 4. pay attention to cleanliness and hygiene, go out or go to the public places must wear a mask. 5. avoid emotional fluctuations or nervousness, to eliminate the fear of. 6. avoid the use of drugs or medication. 7. avoid the use of drugs or medication, avoid the use of drugs.
Diet
Eat soft, high protein, high vitamin, low fat food, eat more fresh fruits and vegetables, avoid spicy, greasy and indigestible food, avoid drinking alcohol.