临床外科杂志 ›› 2026, Vol. 34 ›› Issue (5): 511-512.doi: 10.3969/j.issn.1005-6483.20250482

• 临床病例报道 • 上一篇    下一篇

急性坏疽性阑尾炎合并特发性血小板减少症一例

  

  1. 200036   上海,上海交通大学医学院附属同仁医院普外科
  • 收稿日期:2025-05-11 接受日期:2025-05-11 出版日期:2026-05-20 发布日期:2026-05-20

A case report of acute gangrenous appendicitis complicated with idiopathic thrombocytopenic purpura

  1. Department of General Surgery,Tongren Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200336,China
  • Received:2025-05-11 Accepted:2025-05-11 Online:2026-05-20 Published:2026-05-20

摘要: 本文报道1例17岁男性特发性血小板减少症合并急性坏疽性阑尾炎病人的诊疗经过。病人因转移性右下腹痛就诊,入院时血小板计数3×109/L,予以丙种球蛋白输注等术前准备后行阑尾切除术,术后联合海曲泊帕、特比澳升血小板治疗。住院期间炎症指标持续下降恢复至正常水平,血小板计数则从3×109/L升至530×109/L,各项指标恢复正常并顺利出院。本病例提示此类合并症病情凶险,围手术期输注丙种球蛋白可降低出血风险,术中精细结扎血管是治疗关键,术后需持续升血小板并监测腹腔是否出血。

关键词: 特发性血小板减少症, 急性坏疽性阑尾炎, 丙种球蛋白

Abstract: This paper reports the diagnosis and treatment of a 17-year-old male patient with idiopathic thrombocytopenic purpura complicated with acute gangrenous appendicitis.The patient was admitted for metastatic right lower abdominal pain with a platelet count of only 3×109/L.Emergency preoperative preparation such as intravenous immunoglobulin infusion was given followed by appendectomy.Postoperatively,eltrombopag and thrombopoietin were combined for platelet elevation.During hospitalization,the white blood cell count and neutrophil ratio showed a continuous downward trend,while the platelet count rose rapidly from 3×109/L to 530×109/L at discharge.Inflammatory markers returned to normal and the patient was discharged successfully.This case suggests that such comorbidities are life-threatening.Rapid platelet elevation with intravenous immunoglobulin during the perioperative period and delicate vascular ligation during surgery are the key to treatment,and continuous platelet elevation and abdominal bleeding monitoring are needed postoperatively.

Key words: idiopathic thrombocytopenia, acute gangrenous appendicitis, intravenous immunoglobulin infusion

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