中国普通外科杂志2024，Vol.33Issue(1)：44-51,8.DOI:10.7659/j.issn.1005-6947.2024.01.006
成人免疫性血小板减少性紫癜合并肝血管瘤1例报告并文献复习
Adult immune thrombocytopenia combined with hepatic hemangioma:a case report and literature review
摘要
Abstract
Background and Aims:Adult immune thrombocytopenia(ITP)combined with hepatic hemangioma is clinically rare and prone to misdiagnosis and mistreatment.Here,the authors report the diagnosis and treatment process of a case of adult ITP combined with hepatic hemangioma,aiming to provide reference and insights for clinical practice. Methods:A retrospective analysis of the clinical data of an adult patient with ITP and concomitant hepatic hemangioma admitted to the Second Affiliated Hospital of Guilin Medical College was conducted.The clinical features and treatment characteristics of the disease were summarized in conjunction with relevant literature. Results:The patient,a 46-year-old female,was admitted to the Department of Hematology due to generalized skin and mucosal bleeding for over a month,and thrombocytopenia for 1 d.Blood cell analysis revealed a platelet count of 4.0x109/L,normal coagulation function,and bone marrow aspiration biopsy suggested a relative increase in megakaryocytes with rare platelets.The diagnosis was highly suspicious of ITP.After treatment with steroids and other measures,the skin and mucosal bleeding improved,and the platelet count increased to 59×109/L.Abdominal enhanced CT indicated a massive hemangioma on the right liver,and then,the patient was transferred to the Department of Hepatobiliary and Pancreatic Surgery for resection of the liver hemangioma.After operation,there was significant bleeding in the surgical area,vaginal bleeding,and a gradual decrease in platelets to 3.0×109/L.The right pleural cavity accumulated a large amount of fluid,but coagulation function remained normal.After interventions including hemostasis,transfusion,immune modulation,anti-infection measures,and thoracic puncture drainage,the patient gradually recovered.On the 13th d after operation,the platelet count increased to 220×109/L.Follow-up for 32 months revealed no recurrence of skin and mucosal bleeding,with the platelet count maintained within the normal range. Conclusion:In adult ITP,vigilance is necessary for the presence of concomitant hepatic hemangioma.Treatment of the hemangioma can achieve favorable long-term outcomes,but meticulous perioperative management is essential for the uneventful recovery of patients.关键词
肝肿瘤/血管瘤/紫癜,血小板减少性/Kasabach-Merritt综合征/肝切除术Key words
Liver Neoplasms/Hemangioma/Purpura,Thrombocytopenic/Kasabach-Merritt Syndrome/Hepatectomy分类
医药卫生引用本文复制引用
吴嘉兴,邓维沛,赵东康,蒋建晖,张俊艳,姚红兵..成人免疫性血小板减少性紫癜合并肝血管瘤1例报告并文献复习[J].中国普通外科杂志,2024,33(1):44-51,8.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题基金资助项目(Z20190035) （Z20190035）
广西壮族自治区医疗卫生重点培育学科建设项目基金资助项目(桂卫科教发[2021]8号). （桂卫科教发[2021]8号）
