Leidinger W, Meierhofer J N, Woelfel R
Abteilung für Anästhesie und operative Intensivmedizin, Blutdepot, Klinikum, Auenstrasse 6, 82467 Garmisch-Partenkirchen.
Anaesthesist. 2006 Aug;55(8):868-72. doi: 10.1007/s00101-006-1032-5.
Hepatic rupture after blunt abdominal trauma may lead to severe bleeding, depletion and consumption of clotting factors, with the risk of packing to defer the definitive operation. We report two cases of hepatic rupture after blunt trauma with intrahepatic hematoma and severe intraabdominal bleeding. In both cases the bleeding could be stopped by early intervention with recombinant activated factor VIIa (rFVIIa). In neither case was surgical intervention necessary and after 3 weeks both patients were released without complications. These cases demonstrate that the early therapy with a single dose of rFVIIa before the development of a hemostatic crisis is a therapeutic option in selected cases where surgical therapy of the bleeding is difficult and risky.
钝性腹部创伤后肝破裂可能导致严重出血、凝血因子耗竭和消耗,存在因填塞而推迟确定性手术的风险。我们报告两例钝性创伤后肝破裂合并肝内血肿和严重腹腔内出血的病例。在这两例病例中,通过早期应用重组活化因子VIIa(rFVIIa)进行干预可止血。两例均无需手术干预,3周后两名患者均无并发症出院。这些病例表明,在止血危机发生前早期给予单剂量rFVIIa治疗,对于出血的手术治疗困难且有风险的特定病例是一种治疗选择。