重组凝血因子VII用于非血友病创伤患者难治性出血的综述

A review of recombinant factor VII for refractory bleeding in nonhemophilic trauma patients.

作者信息

Barletta Jeffrey F, Ahrens Christine L, Tyburski James G, Wilson Robert F

机构信息

Department of Pharmacy, Spectrum Health, Grand Rapids, MI 49503, USA.

出版信息

J Trauma. 2005 Mar;58(3):646-51. doi: 10.1097/01.ta.0000154561.97961.ad.

DOI:10.1097/01.ta.0000154561.97961.ad

PMID:15761369

Abstract

BACKGROUND

Recombinant factor VII (rFVII) is an attractive agent to control refractory, coagulopathic bleeding in patients following major surgery. The purpose of this review is to evaluate the published experiences of rFVII in adult, nonhemophilic, surgical and trauma patients.

METHODS

A computerized literature search was conducted to identify articles pertaining to rFVII use for refractory bleeding in adult, nonhemophilic, surgical patients. The selected articles were reviewed and the applicable data was analyzed.

RESULTS

A total of 117 patients were found in 8 case series and 24 case reports. Overall, rFVII was effective in restoring hemostasis in 99/117 (85%) patients with 76/99 (77%) surviving to hospital discharge. In trauma patients, hemostasis was achieved in 20/26 (77%) patients and 17/20 (85%) survived. There were 5 (4%) thromboembolic events observed in the 117 cases and much disparity was noted with the initial dose. Severe acidosis affected the activity of rFVII.

CONCLUSION

Recombinant factor VII is an effective therapeutic agent for achieving hemostasis in nonhemophilic surgical patients. Published clinical experiences, however, are limited to small case series and case reports.

摘要

背景

重组因子VII（rFVII）是控制大手术后患者难治性凝血病性出血的一种有吸引力的药物。本综述的目的是评估rFVII在成年非血友病手术和创伤患者中的已发表经验。

方法

进行计算机文献检索，以识别与rFVII用于成年非血友病手术患者难治性出血相关的文章。对所选文章进行综述并分析适用数据。

结果

在8个病例系列和24篇病例报告中总共发现117例患者。总体而言，rFVII在99/117（85%）的患者中有效恢复止血，其中76/99（77%）存活至出院。在创伤患者中，20/26（77%）的患者实现止血，17/20（85%）存活。在117例病例中观察到5例（4%）血栓栓塞事件，且初始剂量存在很大差异。严重酸中毒影响rFVII的活性。