冷沉淀在结核性毁损肺切除术大量出血中的应用

Application of cryoprecipitate in the treatment of massive bleeding during the pneumectomy of tuberculous destroyed lung

目的总结冷沉淀在结核性毁损肺手术大出血中的应用体会。方法对21例结核性毁损肺手术大出血的病例应用了冷沉淀,并进行了术中出凝血时间及血浆蛋白原浓度的监测。结果 21例大出血的病人中,在出血1 000 ml时有2例出现凝血异常,其中15例在出血1 500 ml时,出凝血时间均异常。21例大出血的病人,在出血1 000 ml时纤维蛋白原浓度低于1.5 g/L有15例,15例在出血1 500 ml时11例纤维蛋白原浓度低于1.0 g/L。结论冷沉淀在结核性毁损肺手术大出血中应用能够纠正血浆中凝血因子的减少,纠正凝血机制异常,减少术中出血,降低手术风险。

Objective To summarize the application of cryoprecipitate in the treatment of massive bleeding during the pneumectomy of tuberculous destroyed lung. Methods 21 patients with massive bleeding during the pneumectomy of tuberculous destroyed lung were treated with cryoprecipitate. Additionally, the intraoperative bleeding time, clotting time and plasma protein level were detected. Results Disorders of bleeding and clotting were found in 2 patients at the blood loss of 1000 ml and 15 patients at 1500 ml. The concentration of fibrinogen lower than 1.5 g/L at the blood loss of 1000 ml was found in 15 patients, and the concentration of fibrinogen lower than 1.0 g/L at the blood loss of 1500 ml was found in 11 patients. Conclusion The application of cryoprecipitate in the treatment of massive bleeding during the pneumectomy of tuberculous destroyed lung can regulate the decrease of clotting factors in plasma and the disorder of clotting mechanism. Besides, it can reduce intraoperative bleeding and lower surgical risks.