What are the best ways to treat purpura? Purpura is a common bleeding disorder. It frequently occurs in children, and its clinical characteristics include spontaneous bleeding of skin and mucous membranes, thrombocytopenia, prolonged bleeding time, poor contraction of blood clots, and increased capillary fragility. Purpura is divided into two types: acute type and chronic type. The acute type is more common, accounting for about 85%, and its prognosis is relatively better than that of adults. Intracranial hemorrhage is the main cause of death, which can occur within 4 weeks of the early onset, and the mortality rate is about 1. Let's follow the experts to learn about Gu Yu's best method for treating purpura.
The best methods to treat purpura are as follows for your reference:
Best method 1 General therapy: Acute cases mainly cause severe bleeding within 1 to 2 weeks of onset, so In the early stages of the disease, activities should be reduced and trauma should be avoided, especially head trauma, and severe cases should rest in bed. Infections should be actively prevented and controlled. Aspirin can cause bleeding and must be avoided. Give adequate fluids and easily digestible food to avoid damage to the luminal mucosa. In order to reduce the tendency of bleeding, large amounts of vitamins C and P are often given. For local bleeding, apply pressure to stop bleeding. General cases do not require special treatment.
Best method 2: Transfuse fresh blood or platelets: only as emergency treatment for severe bleeding. Due to the presence of anti-platelet antibodies in the patient's blood, the transfused blood can be destroyed quickly and has a short lifespan (a few minutes to a few hours). Therefore, blood transfusion or platelet transfusion cannot effectively increase platelet count. However, some people believe that transfusion of platelets can quickly reduce capillary fragility and reduce bleeding tendency.
Best method 3 Adrenocortical hormones: It is generally believed that the efficacy of hormones is due to: ① reducing the permeability of capillaries and bleeding tendencies; ② reducing immune responses and reducing the production and inhibition of paigg Phagocytosis of antibody-attached platelets by splenic monocytes and macrophages. Therefore, after the early application of large amounts of hormones to ITP patients, the bleeding phenomenon can improve quickly.
The best method 4: high-dose intravenous gamma globulin: For children with severe hemorrhage or above, high-dose purified gamma globulin (IGG) can also be infused intravenously, about 0.4g/kg·d. Use it for 5 days. The platelet count can be increased in patients with about 70-80%, and especially for chronic patients, there is a tendency to temporarily replace splenectomy. However, such refined products are expensive and difficult to promote for a while.
Best method 5 Immunosuppressants: Those who are ineffective in hormone therapy can still try: ①Vincristine 1.5~2mg/m2 each time (maximum dose 2mg/time) intravenously injected once a week; or every time 0.5~1mg/m2 plus 250ml of normal saline for slow intravenous infusion, with a course of treatment lasting 4 to 6 weeks. Platelets can be seen to increase after taking the drug, but most patients drop again after stopping the drug, and only a few can achieve long-term relief. Because the effect is short-lived, it is more suitable for preparation before surgery. ② Cyclophosphamide 2 to 3 mg/kg·d orally or 300 to 600 mg/m2 intravenously once a week. It usually takes 2 to 6 weeks to be effective. If it is not effective after 8 weeks, the drug can be discontinued.
Best method 6 Other drugs: In recent years, danazol (dnz), a non-masculine synthetic androgen, has been tried at home and abroad to treat refractory chronic itp For patients, the immediate effect is good and the maintenance effect is short, so it has certain value for those who need to temporarily increase their platelets in preparation for splenectomy surgery. Its role is now believed to be to adjust the immune regulatory function of T cells, thereby reducing the production of antibodies and reducing the elimination of platelets by macrophages.
The best method 7: Splenectomy therapy: The remission rate of splenectomy for chronic ITP is 70 to 75. However, the indications for surgery should be carefully understood and the splenectomy time should be postponed as much as possible