Besser Martin W, MacDonald Stephen G
Department of Haematology.
Department of Specialist Haemostasis, The Pathology Partnership, Addenbrooke's Hospital, Cambridge, UK.
J Blood Med. 2016 Sep 26;7:217-225. doi: 10.2147/JBM.S90693. eCollection 2016.
Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient's fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia.
获得性低纤维蛋白原血症最常见的原因是血液稀释和凝血因子消耗。积极补充纤维蛋白原已成为现代大量出血管理的核心原则之一。确定患者纤维蛋白原水平的最佳方法仍存在争议,特别是在获得性异常纤维蛋白原血症中,根据所选择的定量方法可能会产生重大治疗影响。本综述介绍了现有的实验室方法和床旁检测方法,并讨论了它们的相对优缺点。还讨论了目前纠正低纤维蛋白原血症的策略。