重组活化因子 VII 在有抑制剂的血友病 A 患者择期骨科手术血液管理中的作用。
The role of recombinant activated factor VII in the haematological management of elective orthopaedic surgery in haemophilia A patients with inhibitors.
机构信息
Centre for Bleeding Disorders and Coagulation, Department of Oncology, "Careggi" University Hospital, Florence, Italy.
出版信息
Blood Transfus. 2017 Sep;15(5):478-486. doi: 10.2450/2017.0369-16. Epub 2017 May 16.
Abstract
The clinical profile and expectations of haemophilic patients with inhibitors have changed over the last three decades, mainly because of the prolongation of life-expectancy, often resulting in an increase of the orthopaedic burden. Recombinant activated factor VII (rFVIIa) is the most frequently used bypassing agent in haemophilia patients with inhibitors during elective orthopaedic surgery. For nearly 30 years, rFVIIa has been successfully used to control haemostasis in several major and minor surgical procedures. Clinical trials, case series, reports and surveys were progressively aimed at optimising rFVIIa usage in very demanding conditions managed in highly specialised centres. Recommendations from consensus opinions and guidelines have been provided on the basis of this clinical experience.
摘要
在过去的三十年中，患有抑制剂的血友病患者的临床特征和预期发生了变化，这主要是因为预期寿命的延长，通常导致骨科负担增加。在择期骨科手术中，重组活化因子 VII（rFVIIa）是血友病伴抑制剂患者最常使用的旁路制剂。近 30 年来，rFVIIa 已成功用于控制几种主要和次要手术中的止血。临床试验、病例系列、报告和调查逐渐旨在优化在高度专业化中心管理的非常高要求条件下使用 rFVIIa。基于这些临床经验，提供了共识意见和指南建议。
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