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題 名 | 產後血栓性血小板減少性紫斑症--病例報告與文獻回顧=Postpartum Thrombotic Thrombocytopenic Purpura: A Case Report and Review of the Literature |
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作 者 | 黃禎祿; 蔡鎰和; 鍾孝民; | 書刊名 | 國防醫學 |
卷 期 | 30:1 2000.01[民89.01] |
頁 次 | 頁69-74 |
分類號 | 418.2216 |
關鍵詞 | 血栓性血小板減少性紫斑症; 微血管病變的溶血性貧血; 血漿減除術; Thrombotic thrombocytopenic purpura; Microangiopathic hemolytic anemia; Plasmaphoresis; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:血栓性血小板減少性紫斑症是一種多器官即系統性的疾病,其原因大多不明,發生率也極為罕見,約生產數的二萬五千分之一,常發生於20至40歲女性。 病例報告:本案例是一位22歲的女性,G2P1,懷孕36又3/7週已有前次剖腹產。病人於剖腹產後發現有發燒、僵直性痙攣、血小板減少、微血管病變的溶血性貧血及腎功能衰竭,但新生兒無異常症狀。在一系列的檢查及腎臟細針切片後證實為血栓性血小板減少性紫斑症。在住院過程中,接受多次輸血漿及血漿減除術治療,輸血小板則視為禁忌,因為使病情更惡化,很不幸的此案例於三個月後死於多發性器官衰竭。 結 論:血栓性血小板減少性紫斑症雖然是罕見的疾病,但對孕婦而言是高死亡率或高罹病率的疾病,在懷孕期間常會併發早產或胎死腹中,而要提高孕婦的存活率需積極且儘早輸新鮮冷凍血漿及接受血漿減除術。 |
英文摘要 | Background: Thrombotic thrombocytopenic purpura (TTP) is a multiorgan-systemic disease and the etiology remains unknown. The incidence is rare, about one per 25,000 births. It often occurs between ages 20 and 40 years female. Case report: Patient was a 22-year-old female, G2P1, who developed fever, tonic-clonic seizure, thrombocytopenia, microangiopathic hemolytic anemia and renal dysfunction after cesarean delivery, but the infant was asymptomatic. Under a series of studies and renal needle biopsy, TTP was proved. The plasma transfusion and plasmapheresis were performed. Platelet transfusion should be avoided because it may trigger an exacerbation. Unfortunately, this case expired due to multiorganic failure three months later. Conclusion:The incidence of TTP is rare, presenting with high maternal mortality and long-term morbidity. The frequent complications of TTP during pregnancy are preterm delivery and intrauterine fetal death. Aggressive treatment with plasma transfusion and plasmapheresis improves survival. |
本系統中英文摘要資訊取自各篇刊載內容。