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1例80岁女性患者因尿毒症行血液透析,应用普通肝素,首剂量为24 mg,维持量5.2 mg/h,持续3.5～4 h。15个月后患者出现口腔溃疡,症状逐渐加重,出现创面疼痛、吞咽困难。舌体右侧可见约5 mm×8 mm大小溃疡,右侧口腔黏膜可见约7 mm×9 mm大小溃疡。停用普通肝素,改为低分子肝素3 000 IU,症状改善。3 d后再次透析时再次应用普通肝素,溃疡再次加重。此后,再次改为低分子肝素,溃疡明显好转,但未愈合。随后将封管抗凝药物由普通肝素改为尿激酶。患者口腔溃疡痊愈,未再复发。
One 80-year-old woman undergoing hemodialysis due to uremia was treated with unfractionated heparin at a first dose of 24 mg and a maintenance dose of 5.2 mg / h for 3.5 to 4 h. 15 months later patients with oral ulcers, the symptoms gradually aggravated, there wound pain, difficulty swallowing. Right tongue of the body can be seen about 5 mm × 8 mm size ulcer, the right oral mucosa can be seen about 7 mm × 9 mm size ulcer. Unfractionated heparin, to low molecular weight heparin 3 000 IU, the symptoms improved. Unfractionated heparin was applied again on dialysis 3 days later, and the ulcer was aggravated again. Since then, once again changed to low molecular weight heparin, ulcers significantly improved, but did not heal. Then sealed tube anticoagulant drugs from unfractionated heparin to urokinase. Patients with oral ulcers healed, no recurrence.