What Are Platelet Disorders?

Platelet counts consistently below 100 × 109 / L (L) are very common. It is generally believed that platelets are easily associated with spontaneous bleeding at 50 × 109 / L, and there are often more pronounced spontaneous bleeding at 20 × 109 / L. There are many reasons for thrombocytopenia. According to the mechanism of this, thrombocytopenia is reduced. Certain drugs and viral infections only selectively inhibit bone marrow megakaryocytes and induce thrombocytopenia. In addition, radiation, chemotherapy, tumors or lack of folic acid and vitamin B12 are causing Thrombocytopenia with reduced blood cell production; excessive destruction, including drug immunity and certain autoimmune diseases, idiopathic thrombocytopenic purpura, and platelets caused by diffuse intravascular coagulation and thrombotic thrombocytopenic purpura Excessive consumption; abnormal distribution, often caused by large spleen seizures.

Platelet disease

The English name of platelet disorders is platelet disorders. Platelet disease is a bleeding disorder caused by defects in the quantity or quality of platelets. Normal initial hemostasis requires peripheral blood platelet counts greater than 100,000 / mm (100 × 10 / L) and platelet function to be normal. Platelet numbers represent a balance between the rate of production and the rate of loss or peripheral distribution.

Platelet disease

Thrombocytopenia

Thrombocytosis

The platelet count is consistently higher than 600 × 109 / L. It can be primary to myeloproliferative diseases, especially primary thrombocytosis, and can also be secondary to severe bleeding and hemolysis, malignant tumors (such as lung cancer), and infections (such as tuberculosis). ), Drug response (such as epinephrine), after splenectomy.

Platelet disease

A group of bleeding disorders caused by functional defects such as platelet adhesion, aggregation, release, and coagulation, including two major categories: one is hereditary dysfunction, such as abnormal platelet adhesion (giant platelet syndrome, vascular false blood Friends disease), platelet aggregation abnormalities (platelet weakness, afibrinogenemia), platelet secretion abnormalities (storage pool disease, etc.), platelet factor 3 abnormalities (platelet disease); Common, often secondary to myeloproliferative diseases, uremia, dysproteinemia (multiple myeloma, etc.), drugs (aspirin, pansentin), and other diseases (such as cirrhosis, leukemia, and immune thrombocytopenia) Purpura). Treatment is mainly aimed at the cause, and the primary disease is actively treated, and those with significant bleeding can be transfused with platelet components.

Idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura ITP is a common hemorrhagic disease with hemorrhage and peripheral blood thrombocytopenia, normal or increased bone marrow megakaryocytes, and maturation disorders as its main manifestations. Recently, it has been recognized that this disease is an autoimmune disease caused by the production of autoantiplatelet antibodies in patients, resulting in shortened platelet life, excessive destruction, and reduced number of platelets. ITP is divided into acute and chronic, which are difficult to distinguish in the early stages of the disease. The etiology, pathogenesis and outcome of the two are very different. 80% of children are acute AITP), there is no gender difference, and the disease is easy to occur in spring and winter. Most of them have a history of viral infection and are self-limiting diseases. It is generally considered to be a natural immune response after acute viral infection. Once the cause is cleared, the disease is cured in 6-12 months. Over 95% of adults have chronic ITP (CITP), and the male to female ratio is about 1: 3, which is generally considered to be an autoimmune disease. The case fatality rate is 1%, and most of them die from intracranial hemorrhage.

Platelet disease secondary thrombocytopenic purpura

In addition to the clinical manifestations of bleeding symptoms such as skin and mucous membranes and laboratory tests for thrombocytopenia, there are still characteristics of primary disease. Traditional Chinese medicine belongs to the categories of blood spots, spotted rash, etc.

Causes

1. Drugs that cause low bone marrow regeneration or disorders with reduced whole blood cells. Chemicals and drugs that easily cause bone marrow depression at a certain dose:

Benzene, xylene, etc. Alkylating agents: such as nitrogen mustard, cyclophosphamide, and phenylpropionate nitrogen mustard. anti-metabolic drugs: such as cytarabine, thiopurine and so on. Anticancer antibiotics: such as orthomycin and adriamycin. Others: such as organic arsenic. 2. Medications that can cause bone marrow aplasia or depression: such as chloramphenicol, sulfa drugs, penicillin, streptomycin, Xinqing I, trimethyldiketone, sodium phenytoin, ethosuximide, antithyroid drugs (such as taba Azole, propylthiouracil, meconepine), diabetic drugs (such as metsulfuron, clotrimide, chlorosulfuramide, etc.), butazone, indomethacin, tranquilizers, and sedatives (anning, rimienin , Chlorpromazine, etc.), gold preparations, dyed hair Liu, chlorphenazine, chlorphenazine, acetazolamide, etc.

3. Drugs that selectively inhibit the production of platelets by megakaryocytes: such as chlorothiazide drugs, estrogen drugs, ethanol, mesotrione, restigmycin, etc.

Platelet Disease Daily Care for Platelet Disease

Platelet disease life conditioning

Prevent colds and closely observe the changes of purple spots.

Acute onset, severe bleeding needs to be absolutely bedridden. During the remission period, pay attention to rest to avoid overwork and avoid trauma.

Chronic patients can exercise appropriately according to their physical condition.

If there is a drug allergy, it should be avoided when taking the drug.

Pay attention to clean skin and avoid excessive scratching to prevent scratching infection. If the purple spot has itchy skin, it can be rubbed with calamine lotion or Jiuhua powder lotion.

Platelet disease diet conditioning

1. The diet should be soft and fine. If there is bleeding in the digestive tract, a semi-liquid or liquid diet should be given. It should be cool and not hot. Avoid spicy things such as tobacco and alcohol.

2. Can be used for vegetables and fruits, mung bean soup, lotus seed porridge, avoid hair such as fish, shrimp, crab, fishy food.

3 Avoid hawthorn.

Platelet disease psychiatric conditioning

Regulate emotions and avoid mood swings or mental stimulation.

Platelet disease daily precautions for patients with thrombocytopenic purpura

1. During the remission phase, you can participate in some exercises, such as walking, jogging, and Taijiquan, to enhance your physique and disease resistance.

2. The diet should be regular. The staple foods should be high in protein and high in vitamins, such as wheat, corn, millet, glutinous rice, beans, lean meat, eggs and so on. Eat more fresh fruits, such as oranges, red dates, walnuts, red-skinned peanuts, spinach, green peppers, foraging vegetables, cabbage and so on. Avoid spicy, greasy and indigestible food, tobacco and other irritating items should be eliminated.

3. Try to avoid using drugs that can cause thrombocytopenia, such as rifampicin, aspirin, quinine, cephalosporin, and digitalis.

4. Usually, you should keep your mood comfortable and avoid excessive mental stress. It is necessary to maintain personal hygiene, prevent various infections, and pay particular attention to preventing trauma.

Platelet disease care

1. Closely observe the condition and timely find the critical situation caused by bleeding. Observe the skin petechiae (plaque) changes. Observe the change of platelet number. When the peripheral platelets are less than 20 × 109 / L, spontaneous bleeding often occurs. The smaller the number of platelets, the heavier the bleeding phenomenon, so those with very low platelet numbers need to closely observe the occurrence of bleeding. For severe bleeding, such as epistaxis, visceral bleeding, and intracranial hemorrhage, blood pressure, pulse, and breathing should be measured regularly, observe complexion, and record blood loss. Such as pale, worsening breathing pulses, sweating, and decreased blood pressure suggest hemorrhagic shock. Irritability, lethargy, headache, vomiting, and even convulsions suggest intracranial hemorrhage. Intracranial hemorrhage, irregular breathing slows down, and bilateral pupil sizes vary, suggesting a combined hernia. Intracranial hemorrhage is often life-threatening. Gastrointestinal bleeding is often accompanied by abdominal pain and blood in the stool. Hematuria and low back pain suggest kidney bleeding.

2. Hemostatic nasal and oral mucosal bleeding can be compressed with gauze, cotton balls or gelatin sponges impregnated with 1% ephedrine or 0.1% epinephrine. If the above-mentioned compression hemostasis is not effective, other hemostatic measures are immediately adopted. For severe bleeding, transfusion of platelets of the same blood type is required.

3 Patients with fear elimination may be afraid of bleeding and hemostatic techniques, and crying, restlessness, and non-cooperation may worsen bleeding. Therefore, it is necessary to explain the reason before surgery, try to eliminate the fear, and strive for the cooperation of patients.

4 Avoid injuries The bedside bed rails are wrapped with soft plastic products to limit strenuous activities to avoid bleeding from bumps, punctures and falls. Minimize intramuscular injection to avoid causing deep hematoma. Fast food that is hard and spiny. Keep the stool open, so as not to cause intracranial hemorrhage due to increased abdominal pressure caused by defecation.

5. The prevention room for patients with infection should be separated from the infection room. Take care to keep the bleeding site clean.

6. Health education Guide the method of oppression and hemostasis. Guide self-protection methods. If you are not in contact with the infected patient during the medication, you need to wear a mask and go to the public place with moderate clothing to avoid infection as much as possible to avoid exacerbation or recurrence. Guidance on prevention of trauma. If you do not use hard toothbrushes, do not dig nostrils, do not play sharp toys and tools, do not do sports that are prone to trauma. The prognosis of hemolytic anemia is mostly good. However, a small number can be changed to chronic or recurrent. Therefore, parents should be instructed to identify signs of bleeding, such as petechiae, black stools, and return to hospital for review and treatment as soon as bleeding is found. Patients treated with splenectomy are susceptible to respiratory and skin purulent infections, and even sepsis. Within 2 years after surgery, patients should follow up regularly, taking oral penicillin several days a month or injecting long-acting penicillin once intramuscularly and injecting gamma globulin as appropriate to enhance anti-infective ability.