临床误诊误治2018，Vol.31Issue(1)：34-37,4.DOI:10.3969/j.issn.1002-3429.2018.01.012
剖宫产后TTP致妊娠相关急性肾损伤一例经验与教训
Experiences and Lessons of One Postpartum Thrombotic Thrombocytopenic Purpura with Hemorrhage Lead to Preg-nancy-related Acute Kidney Injury
杨新军 1林静 1汪晶华 1刘宇 1陈云爽 1吴广礼1
作者信息
- 1. 050082 石家庄,解放军白求恩国际和平医院肾脏病科
- 折叠
摘要
Abstract
Objective To investigate pathogenesis and the treatment measure of patients with acute kidney injury ( AKI) after cesarean in order to improve rescuing ability of pregnancy-related acute kidney injury ( PR-AKI) . Methods Clinical data of one patient with PR-AKI at postoperative 5th d after cesarean section was retrospectively analyzed. Results A 31-year old woman was admitted for edema and oliguresis at postoperative 5th d after cesarean section, and she was diagnosed as having AKI caused by thrombotic thrombocytopenic purpura ( TTP) , combined with infection, anemia, thrombocytopenia, liver and renal function damage, high phosphocreatinase, thrombin dysfunction. Physical examination discovered the hemato-ma in the right femoral vein and abdominal hematoma was confirmed by ultrasonic testing. She accepted embolotherapy when arteriography verified the bleeding of two branchs in the right internal iliac artery. In course of disease, she had nasal bleeding and haemorrhoids bleeding. She had accepted anti-infection, hemofiltration and glucocorticoid therapy, recoveried and dis-charged two and a half months later. Conclusion Both the TTP and postpartum hemorrhage are importance pathogenesis of PR-AKI, the patient′s condition worsened when they coexistd. If inoperable, angiograph testing can clear and definite the bleeding reason and position, reduce the misdiagnosis, electivity transarterial embolization can prevent the illness and recovery renal function.关键词
剖宫产术/手术后并发症/产后出血/急性肾损伤/紫癜,血栓性血小板减少性Key words
Cesarean/Complication/Postpartum hemorrhage/Acute kidney injury/Purpura/thrombotic thrombocy-topenic purpura分类
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杨新军,林静,汪晶华,刘宇,陈云爽,吴广礼..剖宫产后TTP致妊娠相关急性肾损伤一例经验与教训[J].临床误诊误治,2018,31(1):34-37,4.
