Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Am J Emerg Med. 2012 Sep;30(7):1319.e1-4. doi: 10.1016/j.ajem.2011.05.010. Epub 2011 Jul 29.
Peptic ulcer bleeding is thought to be a major cause of bleeding in patients with end-stage renal disease and is more complicated in uremic patients. We described a 41-year-old man with end-stage renal disease who underwent hemodialysis with refractory ulcer bleeding, failure to all traditional peptic ulcer treatments, and correction of uremic component, who has been successfully treated by using recombinant factor VIIa. There have been few case reports in dealing refractory upper gastrointestinal bleeding in uremic patients in the literature; and in this case report, we demonstrates that recombinant factor VIIa could be used as a rescue therapy in these high–surgical risk patients when medical therapy fails.
消化性溃疡出血被认为是终末期肾病患者出血的主要原因，且在尿毒症患者中更为复杂。我们描述了一位 41 岁的男性终末期肾病患者，他在接受血液透析治疗时出现难治性溃疡出血，所有传统的消化性溃疡治疗均无效，且尿毒症相关因素也未得到纠正，但使用重组 VII 因子后成功治疗。在文献中，针对尿毒症患者难治性上消化道出血的处理方法，仅有少数病例报告；在本病例报告中，我们证实当药物治疗失败时，重组 VII 因子可作为此类高手术风险患者的抢救治疗方法。
