最近审阅: 26 九月 2020
最近更新: 06 五月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 近期肝素暴露史
  • HIT 史
  • 非环境和药物因素导致血小板减少
  • 近期手术或外伤史
  • 近期发生动静脉血栓栓塞事件(例如:肺栓塞、深静脉血栓、脑卒中、心肌梗死)
  • 肝素注射部位坏死

其他诊断因素

  • 无出血
  • 肾上腺出血性坏死征象
  • 急性全身反应
  • 静脉肢体坏疽迹象

危险因素

  • 近期肝素接触(过去100天内)
  • 近期骨科和心血管手术
  • 女性

诊断性检查

首要检查

  • 全血细胞计数(FBC)
更多 首要检查

需考虑的检查

  • 瓦尔肯廷(4Ts)概率量表
  • 肝素诱导性血小板减少症抗原检测
  • HIT 功能性检测
  • 凝血功能检查
  • 静脉多普勒超声
  • 计算机断层扫描肺血管造影(CTPA)
  • 通气-灌注扫描(V/Q 扫描)
  • 计算机体层成像脑静脉造影
  • 磁共振静脉成像(头部)
更多 需考虑的检查

治疗流程

撰稿人

Associate Professor

Department of Medicine

McMaster University

Thrombosis Consultant

Juravinski Hospital and Cancer Centre

Hamilton

Ontario

Canada

利益声明

LL is an author of several references cited in this topic. LL has received consulting fees from Janssen for data adjudication for a clinical trial. Janssen distributes rivaroxaban, which is mentioned as a treatment option for HIT.

同行评议者展开全部内容

Assistant Clinical Professor of Medicine

Acting Associate Chair of the Division of Hematology and Medical Oncology

University of Connecticut School of Medicine

Farmington

CT

利益声明

JSW declares that he has no competing interests.

Consultant Haematologist

Aberdeen Royal Infirmary

Foresterhill Health Campus

Aberdeen

UK

利益声明

HW declares that he has no competing interests.

Clinical Scientist

Royal Brompton Hospital

Honorary Clinical Lecturer

Imperial College London

London

UK

利益声明

SD is a consultant for Mitsubishi Pharma, the manufacturer of argatroban.

内容使用需遵循免责声明