肝素诱导的血小板减少症是儿童对普通肝素和低分子量肝素的罕见且严重的反应。快速识别,肝素停药,随后的抗凝剂治疗是预防血栓和截肢等严重并发症的重要步骤.这篇综述的目的是描述儿童肝素诱导的血小板减少症的临床特征,并总结其治疗可用的数据。本文总结了数据,并将直接凝血酶抑制剂的使用与临床结果联系起来。与Ovid进行了文献检索,使用关键术语argatrban,bivalirudin,hirulog,danapoid,lepirudin,直接凝血酶抑制剂,肝素诱导的血小板减少症,血栓形成,华法林,还有磺达肝素.如果文章被归类为社论,则被排除在外,评论文章,或会议摘要,或者如果他们涉及18岁或以上的患者或描述的疾病状态与血栓形成无关。本综述确定并评估了19篇包含33例病例报告的文章。在33个案例中,14、10、4和2例描述了lepirudin的使用,danapoid,argatrban,还有比瓦卢定,分别。两例未报告所用抗凝剂的类型,1例使用阿司匹林。最常见的并发症是出血。
Heparin-induced thrombocytopenia is a rare and serious reaction to unfractionated heparin and low-molecular-weight heparins in children. Quick recognition, discontinuation of heparin, and subsequent treatment with an alternative anticoagulant are essential steps to prevent serious complications such as thrombus and limb amputation. The purpose of this
review is to describe the clinical features of heparin-induced thrombocytopenia in children and to summarize the data available for its management. This paper summarizes data and relates the use of direct thrombin inhibitors with clinical outcomes. A literature search was conducted with Ovid, using the key terms argatroban, bivalirudin, hirulog, danaparoid, lepirudin, direct thrombin inhibitor, heparin-induced thrombocytopenia, thrombosis, warfarin, and fondaparinux. Articles were excluded if they were classified as editorials,
review articles, or conference abstracts or if they involved patients 18 years of age or older or described disease states not related to thrombosis. Nineteen articles containing 33 case reports were identified and evaluated for this
review. Of the 33 cases, 14, 10, 4, and 2 cases described the use of lepirudin, danaparoid, argatroban, and bivalirudin, respectively. Two cases did not report the type of anticoagulant used, and 1 case used aspirin. The most commonly reported complication was bleeding.