Tomita Emi, Takase Hajime, Tajima Keiichi, Suematsu Yoshihiro
Department of Anesthesiology, Tsukuba Memorial Hospital, Tsukuba, Japan.
Kyobu Geka. 2015 Aug;68(9):735-9.
Recombinant activated factor VII (rFVIIa) has been used for the treatment of hemophilia, factor VII deficiency, and Glanzmann's thrombasthenia. We retrospectively reviewed the effectiveness of rFVIIa for the treatment of uncontrollable bleeding after cardiovascular surgery.
Eight patients received rFVIIa for the treatment of uncontrollable bleeding after admission to the intensive care unit following cardiovascular surgery between April 2009 and July 2014.
Blood loss was significantly decreased in 7 of the 8 cases after the administration of rFVIIa (p<0.05). No adverse thromboembolic events were encountered. The quantity of blood loss and prothrombin time-international normalized ratio(PT-INR), activated partial thromboplastin time(APTT), fibrin degradation products(FDP) and D-dimer levels decreased significantly after the administration of rFVIIa (p<0.05). The blood coagulation test values were almost within the normal range at 24 hours after administration.
In appropriately selected patients, rFVIIa is an effective agent for the treatment of excessive bleeding after cardiovascular surgery.
重组活化因子VII（rFVIIa）已用于治疗血友病、因子VII缺乏症和血小板无力症。我们回顾性分析了rFVIIa治疗心血管手术后难以控制的出血的有效性。
2009年4月至2014年7月期间，8例患者在心血管手术后入住重症监护病房时接受rFVIIa治疗难以控制的出血。
8例患者中有7例在给予rFVIIa后失血量显著减少（p<0.05）。未发生不良血栓栓塞事件。给予rFVIIa后，失血量以及凝血酶原时间-国际标准化比值（PT-INR）、活化部分凝血活酶时间（APTT）、纤维蛋白降解产物（FDP）和D-二聚体水平均显著降低（p<0.05）。给药后24小时凝血试验值几乎在正常范围内。
在适当选择的患者中，rFVIIa是治疗心血管手术后出血过多的有效药物。
