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作者报道2例与溶栓治疗和伴用肝素抗凝有关的自发性脾破裂。例1,70岁,男性,9个月前曾作左股-腘动脉搭桥术和术中血管成形术。入院第一天,动脉造影示双侧髂动脉有严重动脉粥样硬化性病变,搭桥处完全阻塞。开始以100 000U/h连续动脉灌注尿激酶。导管通过弥漫性病变的髂动脉同时,静注1 000U肝素,再以700U/h灌注。第五天晨,患者出现腹胀、尿量锐减、轻度心动过速和低血压,血细胞容积减至33.2%。立即停用肝素和尿激酶。腹部超声证实腹腔内有游离液体,但腹膜后无液体。腹部穿刺液呈血性。紧急剖腹探查发现,
The authors reported two cases of spontaneous splenic rupture associated with thrombolysis and heparin anticoagulation. Example 1, 70 years old, male, left thigh-popliteal artery bypass grafting and intraoperative angioplasty 9 months prior. The first day of admission, arterial angiography showed bilateral iliac artery with severe atherosclerotic lesions, bypass completely blocked. Start continuous urokinase at 100 000 U / h. Catheter through the diffuse lesion iliac artery at the same time, intravenous 1 000U heparin, then 700U / h perfusion. On the fifth day, the patient experienced abdominal distension, sharp drop in urine output, mild tachycardia and hypotension, and the hemocytic volume was reduced to 33.2%. Stop using heparin and urokinase immediately. Abdominal ultrasound confirmed the presence of free fluid in the abdominal cavity, but no fluid after retroperitoneal. Abdominal puncture fluid was bloody. Emergency laparotomy found that,