减低剂量凝血因子替代治疗在血友病患者微创手术中的疗效

Efficacy of Reduced-dose Coagulation Factor Replacement Therapy in Minimally Invasive Surgery for Hemophilia Patients

目的探讨减低剂量凝血因子替代治疗在血友病患者进行微创手术时的疗效。方法回顾性分析2012年3月~2019年12月我院行血友病微创外科手术的8例患者临床资料,均按照围手术期凝血因子替代治疗方案进行治疗,分析治疗情况、围手术期止血情况分级、术中出血量、术后引流量、凝血因子用时、住院时间、凝血因子用量及并发症发生情况。结果8例患者行9次微创手术均顺利完成,围手术期止血情况分级判定均为极佳(E级)。术中出血量(20.00±13.45)ml、术中出血量(57.22±34.98)ml、凝血因子用时(5.44±2.19)d、住院时间(13.54±7.48)d、凝血因子用量(260.44±111.63)U/kg。所有手术均未出现急性出血、延迟性出血、血栓、凝血因子抑制物、血制品相关病毒感染、手术部位感染等并发症。结论减低剂量凝血因子替代治疗在血友病患者微创手术中的疗效满意,在获得良好止血效果的同时,可减少并发症发生风险。

Objective To explore the efficacy of reduced-dose coagulation factor replacement therapy in patients with hemophilia undergoing minimally invasive surgery.Methods The clinical data of 8 patients undergoing minimally invasive surgery for hemophilia in our hospital from March 2012 to December 2019 were retrospectively analyzed.All patients were treated according to the perioperative coagulation factor replacement treatment plan,and the treatment status and perioperative period were analyzed.Grading of hemostasis,intraoperative bleeding volume,postoperative drainage volume,coagulation factor time,hospital stay,coagulation factor dosage,and complications occurred.Results 8 patients underwent 9 minimally invasive operations successfully,and the perioperative hemostasis classification was excellent(grade E),intraoperative blood loss(20.00±13.45)ml,intraoperative blood loss(57.22±34.98)ml,coagulation factor time(5.44±2.19)d,hospital stay(13.54±7.48)d,clotting factor dosage(260.44±111.63)U/kg.No complications such as acute bleeding,delayed bleeding,thrombosis,coagulation factor inhibitors,blood product-related viral infections,or surgical site infections occurred in all operations.Conclusion The reduced-dose coagulation factor replacement therapy is satisfactory in minimally invasive surgery for patients with hemophilia.While obtaining a good hemostatic effect,it can reduce the risk of complications.