1例行右侧膝关节置换术的74岁女性患者,术后预防性应用那屈肝素钙6150 U皮下注射,1次/d。术后第3天,患者右侧腰部、右髋关节处出现瘀斑。血常规检查示血小板计数49×109/L,血红蛋白81 g/L。给予患者输注浓缩红细胞400 ml,但瘀斑范围扩大至对侧腰部及背部。术后第5天考虑那屈肝素钙与血小板减少有关,遂停用。术后第8天,瘀斑颜色转淡,血小板计数88×109/L。第10天,患者出院,出院时血小板计数为123×109/L。 A 74-year-old woman with a right knee replacement underwent prophylactic naltrexone 6,150 U subcutaneously once per day for postoperative prophylaxis. On the third day after operation, ecchymosis appeared on the right hip and right hip of the patient. Blood tests showed platelet count 49 × 109 / L, hemoglobin 81 g / L. Patients were given infusion of 400 ml of concentrated erythrocytes, but the ecchymosis range was extended to the contralateral waist and back. On the 5th postoperative day, nadroparin calcium was considered to be associated with thrombocytopenia and was discontinued. On the 8th postoperative day, the color of ecchymosis turned pale and the platelet count was 88 × 109 / L. On the 10th day, the patient was discharged and the platelet count at discharge was 123 × 109 / L.