Rodriguez-Merchan E Carlos
a Department of Orthopaedic Surgery , La Paz University Hospital-IdiPaz , Madrid , Spain.
Hosp Pract (1995). 2017 Dec;45(5):187-191. doi: 10.1080/21548331.2017.1384689. Epub 2017 Oct 3.
Local fibrin glue (FG) appears to be a useful local haemostatic agent for severe haemorrhage in people with haemophilia (PWH) undergoing surgical procedures.
To evaluate the role of local FG in PWH.
A review of the literature on the topic has been performed.
Local FG is not always necessary to achieve haemostasis in all surgical procedures performed in PWH. However, it could be a good adjunct therapy, primarily when a surgical field will bleed more than expected (e.g. patients with inhibitors), and also for circumcisions, dental extractions, and surgical treatment of pseudotumours.
Although correct surgical haemostasis can typically be achieved by the infusion of factor concentrate at the adequate dose, my recommendation for surgeons is always to have local FG by their side. Local FG appears to be an effective adjunctive therapy for cases in which bleeding is likely (e.g. patients with inhibitors), and for circumcisions, oral surgery, and treatment of pseudotumours. Through the use of local FG, the doses of factor concentrate necessary to prevent bleeding could be reduced, providing considerable cost savings.
局部纤维蛋白胶(FG)似乎是血友病患者(PWH)在接受外科手术时用于严重出血的一种有用的局部止血剂。
评估局部FG在PWH中的作用。
对该主题的文献进行了综述。
在PWH进行的所有外科手术中,并非总是需要局部FG来实现止血。然而,它可能是一种很好的辅助治疗方法,主要适用于手术区域出血比预期更多的情况(例如有抑制剂的患者),也适用于包皮环切术、拔牙以及假肿瘤的手术治疗。
虽然通常通过输注足够剂量的凝血因子浓缩物可以实现正确的手术止血,但我对外科医生的建议始终是让局部FG随时可用。局部FG似乎是出血可能性较大的情况(如有抑制剂的患者)以及包皮环切术、口腔手术和假肿瘤治疗的有效辅助治疗方法。通过使用局部FG,可以减少预防出血所需的凝血因子浓缩物剂量,从而节省大量成本。