CAJ | 학술논문

目的：出血是真性红细胞增多症（PV）的表现之一，与血栓倾向并存容易被忽视。通过对1例PV病史的回顾，促进对PV患者出血并发症的认识。方法回顾我院收治的1例PV患者，结合文献讨论患者的临床表现并总结治疗策略。结果 PV患者出血表现随着抗血小板聚集和放血治疗由隐匿到明显，经内科止血治疗停止，同时红细胞比容降至正常水平。文献回顾可见PV患者并发各种出血表现并不罕见，但消化道出血较少见，多种因素影响PV患者出血倾向，除了血细胞数量指标，凝血指标也是指导PV治疗的重要参考。结论应当根据血栓发生危险度选择适当的治疗策略，综合分析血栓和出血倾向，选择适当治疗措施，防治PV的出凝血异常。
목적：출혈시진성홍세포증다증（PV）적표현지일，여혈전경향병존용역피홀시。통과대1례PV병사적회고，촉진대PV환자출혈병발증적인식。방법회고아원수치적1례PV환자，결합문헌토론환자적림상표현병총결치료책략。결과 PV환자출혈표현수착항혈소판취집화방혈치료유은닉도명현，경내과지혈치료정지，동시홍세포비용강지정상수평。문헌회고가견PV환자병발각충출혈표현병불한견，단소화도출혈교소견，다충인소영향PV환자출혈경향，제료혈세포수량지표，응혈지표야시지도PV치료적중요삼고。결론응당근거혈전발생위험도선택괄당적치료책략，종합분석혈전화출혈경향，선택괄당치료조시，방치PV적출응혈이상。
Objective Hemorrhage which is one of the manifestations of polycythemia vera(PV),coexisted with thrombogen is easy to be ignored.Through the review of one case with PV,to promote the awareness of PV in patients with bleeding complications. Methods To discuss the clinical manifestations of one patient with PV in our hospital and to summarize the therapeutic strategy combining literature. Results Hemorrhage of PV patients had been obvious from hidden as anti platelet aggregation and bloodletting therapy,and stopping at hemostatic of internal medicine,while the hematocrit had decreased to normal level.The review of literature could be found that,PV patients with various kinds of hemorrhage was not uncommon,gastrointestinal hemorrhage was rare,various factors were the influence of PV patients with bleeding tendency.In addition to the number of blood cells, blood coagulation index was an important reference index of PV patients. Conclusion Based on the thrombosis risk, the comprehensive analysis of thrombosis and bleeding tendency,to selected an appropriate treatment strategy and to control the leeding and clotting abnormalities of PV patients.