Pivalizza Evan G, Escobar Miguel A
Department of Anesthesiology, University of Texas Health Science Center, Houston, MSB 5.020, 6431 Fannin St., Houston, TX 77030, USA.
Anesth Analg. 2008 Aug;107(2):398-401. doi: 10.1213/ane.0b013e31817b7864.
A patient with hemophilia and factor VIII inhibitors required urgent evacuation of a spinal cord hematoma. Two large doses of recombinant factor VIIa (200 microg/kg followed by 300 microg/kg) were required for hemostasis. Traditional and rotational thrombelastography were used to guide dose and timing of rFVIIa therapy. With the limitations of prothrombin and partial thromboplastin times as perioperative monitors of rFVIIa efficacy, this description of thrombelastography supports reports of in vitro use, and may be helpful when large perioperative doses of rFVIIa are required.
一名患有血友病且存在凝血因子 VIII 抑制剂的患者需要紧急清除脊髓血肿。为实现止血，需要使用两剂大剂量的重组凝血因子 VIIa（先给予 200 微克/千克，随后给予 300 微克/千克）。采用传统血栓弹力图和旋转血栓弹力图来指导重组凝血因子 VIIa 治疗的剂量和时机。鉴于凝血酶原时间和部分凝血活酶时间作为重组凝血因子 VIIa 疗效的围手术期监测指标存在局限性，本文对血栓弹力图的描述支持了其体外应用的报道，并且在围手术期需要大剂量重组凝血因子 VIIa 时可能会有所帮助。
