Ⅶ因子治疗严重非血管性出血的临床观察

Ⅶ factor Treat Severe Vascular Hemorrhage and Literature Review

目的：总结重组人凝血因子Ⅶa（rFⅦa）治疗非血管性出血的治疗经验。方法：时我科自2009年10月～2014年11月50例肺癌术后因非血管性严重出血的患者应用rFⅦa治疗后进行回顾性分析，其中男性32例，女性18例，年龄38～79岁，平均58．50±5．28岁。手术包括左肺上叶切除15例，左肺下叶切除12例，右肺中上叶切除10例，右肺下叶切除13例。监测应用rFⅦa前后的治疗效果及不良反应，并对国内已报道的应用Ⅶ因子治疗危重出血患者的报道进行文献复习及讨论。结果：50例肺癌术后严重非血管性出血的患者应用rFⅦa后，49例有效，1例无效，49例有效患者出血迅速停止，胸腔引流量明显减少，未发现肺栓塞、心肌梗死及其他血栓性并发症。结论：对于肺癌术后的严重非血管性出血的患者，应用常规止血药治疗无效时及时应用rFⅦa可获得满意的治疗效果，并可减少引流量，降低血液制品的输注，且不良反应发生率低，减少患者死亡率。

Objective： To summarize the treatment experience of human recombinant coagulation factor VR a （ rF Ⅶ a） treating non vascular hemorrhage. Methods： To retrospective analysis 50 cases of postoperative lung cancer because of non vascular patients of serious bleeding from Oct 2009 to Nov 2014 in our hospital. Men 18 cases, women 32 cases,38 to 79 years old, average 58.50±5.28 years. Surgery included 15 left upper lobe resection, Left lower lobe resection in 12 cases, 10 cases of upper right lung lobe resection, character- ized by lower lobe resection 13 cases. Monitoring therapeutic effect and adverse reactions before and after the application of rF Ⅶ a, And the domestic has reported the application of factor Ⅶ treatment of severe hemorrhage patients reported literature review and discussion. Results： 50 cases of lung cancer patients with severe postoperative non vascular hemorrhage after the application of rF VII a, 49 cases ef- fective, 1 case was ineffective, 49 patients with effective stop bleeding quickly, chest lead flow decreased significantly, pulmonary embol- ism, myocardial infarction, and are not found in other thrombotic complications. Conclusion： For lung cancer patients with postoperative serious non vascular hemorrhage, the routine hemostatic treatment is invalid timely application of rF Ⅶ a can obtain satisfactory therapeu- tic effect, and reduce traffic, reduce the infusion of blood products.decrease incidence of adverse reactions, reduce mortality.