Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2018; 17: 60-63
Опыт проведения эндоскопии желудочно-кишечного тракта и бронхоскопии у детей с тромбоцитопенией
https://doi.org/10.24287/1726-1708-2018-17-1-60-63Аннотация
Список литературы
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Pediatric Hematology/Oncology and Immunopathology. 2018; 17: 60-63
Endoscopy for children with thrombocytopenia: Single center experience
https://doi.org/10.24287/1726-1708-2018-17-1-60-63Abstract
Oncological, hematological and immunological diseases themselves or in the course of treatment are often accompanied by a decrease in the parameters of peripheral blood. If there are indications for endoscopy, the doctor performing the research should necessarily evaluate the safety of the procedure and the risks of bleeding in thrombocytopenia. To date, there are no single hematological criteria in the world for safe endoscopy procedure. The aim of the work is to evaluate the possibility of carrying out endoscopic studies in patients with thrombocytopenia and to determine the indications for blood transfusion therapy. The retrospective analysis included 82 patients aged 2 months to 18 years (median age – 9.6 years), who were treated at the Dmitry Rogachev National Center from January 2016 to March 2017, and who underwent diagnostic endoscopy with a platelet count ≤ 50×109/l or an endopic study with biopsy at a platelet count of ≤ 80×109/l, and 19 patients aged 1–18 years (median – 9.26 years), whom endoscopy was performed with prophylactic platelets transfusion. In the endoscopic examination, contact bleeding was observed in 17% of patients who did not receive prophylactic transfusion of platelets and in 21% of patients who underwent transfusion of platelet suspension prior to the study. When carrying out the diagnostic procedure (bronchoscopy and gastroscopy) with a platelet count of more than 20×109/l (median – 34×109/l), no spontaneous bleeding was observed, as well as minimal hemorrhagic syndrome. A safe endoscopy examination is possible to perform even in patients with thrombocytopenia, but clearly defined indications.
References
1. American Society for Gastrointestinal Endoscopy. Guidelines on the management of anticoagulation and antiplatelet therapy for endoscopic procedures. GastrointestEndosc 1998; 48: 672-5.
2. Volkova S.A., Borovkov N.N. Osnovy klinicheskoi gematologii: uchebnoe posobie - N. Novgorod: Nizhegorodskaya gos. med. akademiya, 2013.
3. Schiffer CA. Prophylactic platelet transfusion. Transfusion 1992; 32: 295-8.
4. Samama C.M., Djoudi R., Lecompte T., Denizot N., Schved J.F. Agence Française de Sécurité Sanitaire des Produits de Santé expert group. Perioperative platelet transfusion: recommendations of the Agence Française de Sécurité Sanitaire des Produits de Santé (AFSSaPS) 2003. Can J Anaesth 2005; 52: 30-7.
5. Buderus S., Sonderkőtter H., Fleischhack G., Lentze M.J. Diagnostic and Therapeutic Endoscopy in Children and Adolescents with Cancer. Ped Hematol Oncol 2012; 29: 450-60.
6. Anderson M.A., Ben-Menachem T., Gan S.I., Appalaneni V., Banerjee S., Cash B.D., Fisher L., et al. ASGE Standards of Practice Committee. Management of antithrombotic agents for endoscopic procedures. Gastrointest Endosc 2009; 70: 1060-70.
7. Van Os E.C., Kamath P.S., Gostout C.J., Heit J.A. Gastroenterological procedures among patients with disorders of hemostasis: evaluation and management recommendations. Gastrointest Endosc 1999; 50: 536-43.
8. Cuker A., Cines D.B. Immune thrombocytopenia. Hematology Am Soc Hematol Educ Program 2010; 377-84.
9. Neunert C., Lim W., Crowther M., Cohen A., Solberg L.Jr., Crowther M.A. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood 2011; 117 (16): 4190-207.
