接受预防剂量依诺肝素治疗的患者出现超治疗性抗Xa因子水平：病例系列
Supratherapeutic anti-factor Xa levels in patients receiving prophylactic doses of enoxaparin: A case series.
作者信息
Pannucci Christopher J, Varghese Thomas K, Graves Kencee K, Prazak Ann Marie
机构信息
Division of Plastic Surgery, Division of Health Services Research, University of Utah, 30 North 1900 East, 3B400, Salt Lake City, UT 84132, United States.
Division of Cardiothoracic Surgery, University of Utah, 30 North 1900 East, SOM 3C-127, Salt Lake City, UT 84132, United States.
出版信息
Int J Surg Case Rep. 2016;28:114-116. doi: 10.1016/j.ijscr.2016.09.034. Epub 2016 Sep 25.
INTRODUCTION
Enoxaparin prophylaxis prevents venous thromboembolism in surgical patients. Real time anti-Factor Xa monitoring for surgical patients on enoxaparin prophylaxis is increasingly common.
PRESENTATION OF CASES
We report on three cancer patients with therapeutic or supratherapeutic anti-Factor Xa levels while on prophylactic doses of enoxaparin after surgical procedures. In all cases, elevated anti-Factor Xa levels were the result of blood specimens being removed from a heparinized chemoport.
DISCUSSION
This case series highlights the importance of peripheral venipuncture or appropriate blood wasting from central access sites for anti-Factor Xa levels.
CONCLUSION
Inappropriately drawn anti-Factor Xa levels may contribute to prophylaxis interruption or unnecessary workup for renal or liver failure.
引言
依诺肝素预防可防止外科手术患者发生静脉血栓栓塞。对接受依诺肝素预防治疗的外科手术患者进行实时抗Xa因子监测越来越普遍。
病例介绍
我们报告了3例癌症患者，他们在手术后接受预防性剂量依诺肝素治疗时，抗Xa因子水平达到治疗或超治疗水平。在所有病例中，抗Xa因子水平升高是由于从肝素化化疗端口采集血样所致。
讨论
本病例系列强调了外周静脉穿刺或从中心通路部位适当放血对于抗Xa因子水平检测的重要性。
结论
抗Xa因子水平检测样本采集不当可能导致预防治疗中断，或引发对肾衰竭或肝功能衰竭的不必要检查。
Zotero 插件