新型外科技术可促进血友病患者的手术止血。
New Surgical Technologies Could Facilitate Surgical Hemostasis in Hemophilic Patients.
作者信息
Panovski Milcho J, Fildishevski Igor V, Ognjenovic Ljubomir Lj, Dejanova-Ilijevska Violeta I
机构信息
University Clinic for Digestive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
National Center for Hemophilia, Republic Institute for Transfusiology, Vodnjanska 17, Skopje 1109, Republic of Macedonia.
出版信息
Open Access Maced J Med Sci. 2017 May 25;5(3):295-298. doi: 10.3889/oamjms.2017.062. eCollection 2017 Jun 15.
BACKGROUND
It's assumed that surgery in haemophilia can be accomplished these days safely.
AIM
The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs.
METHODS
Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery. We used the available surgical technologies and techniques with a proven value in the best clinical practice, to achieve proper and permanent hemostasis. Postoperatively, the replacement therapy and thromboembolic prophylaxis was continued according to the international guidelines for the management of haemophilia.
RESULTS
The operative and post-operative periods were uneventful. No significant differences were found in the operation time in our hemophilic patients versus non-hemophilic patients. Significant differences related to the hospital stay duration were found in both patients compared with controls, due to the necessary replacement therapy.
CONCLUSION
With new surgical technologies, proper and permanent hemostasis can be achieved, without prolonging the operation time.
背景
目前认为血友病患者如今可安全接受手术。
目的
本研究旨在探讨新手术技术对血友病患者围手术期管理及手术结果的影响。
方法
两名轻度甲型血友病患者接受了手术（腹腔镜阑尾切除术和腹股沟疝修补术）。两名患者均在手术前30分钟开始使用凝血因子VIII进行替代治疗。我们采用了在最佳临床实践中已证实有价值的现有手术技术和方法，以实现适当且持久的止血。术后，根据血友病管理的国际指南继续进行替代治疗和血栓栓塞预防。
结果
手术期和术后均顺利。我们的血友病患者与非血友病患者在手术时间上未发现显著差异。由于需要进行替代治疗，两名患者与对照组相比，在住院时间上存在显著差异。
结论
采用新手术技术可实现适当且持久的止血，而不延长手术时间。
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