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1例77岁男性患者,因拟行射频消融术,术前给予预防性抗凝治疗,皮下注射那屈肝素钙6150U,1次/12h。2d后患者出现晨起头晕、晕厥、腹痛,腹部可触及包块。停用那屈肝素钙。之后患者呕吐咖啡样胃内容物约200mL,BP80/50mmHg,HR110次/min。CT检查示腹部肿块。次日左侧腰腹部出现瘀斑,腹部包块明显增大,张力增高,触痛明显。Hb74g/L。腹部超声检查:肝周、肾周、脾周及腹腔存在少量积液。那屈肝素钙停用48h后Hb80g/L。随后给予对症支持治疗,上述症状逐渐好转。停用4d后开始进流食,未再发生消化道出血。停用4周后Hb120g/L,随访8个月病情稳定。
A 77-year-old male patient undergoing radiofrequency ablation and premedication for prophylactic anticoagulation was administered subcutaneously with naltrexone calcium 6150U once daily for 12 hours. 2d after the patient appeared dizzy morning, fainting, abdominal pain, abdominal palpable mass. Stop nadroparin calcium. After the patient vomit coffee-like stomach contents of about 200mL, BP80 / 50mmHg, HR110 times / min. CT examination showed abdominal mass. The next day the left side of the abdomen appear ecchymosis, abdominal mass was significantly increased, increased tension, tenderness significantly. Hb74g / L. Abdominal ultrasound: liver, kidney, spleen and abdominal a small amount of effusion. Nadroparin calcium 48h after Hb80g / L. Followed by symptomatic and supportive treatment, the symptoms gradually improved. After stopping the 4d into the flow of food, no recurrence of gastrointestinal bleeding. Hb120g / L after 4 weeks of deactivation was stable after 8 months of follow-up.