维生素K、新鲜冰冻血浆和血小板输注用于阻止一名正在服用抗凝剂和抗血小板药物的患者在创伤性脑损伤后颅内出血的进展。
Vitamin K, fresh frozen plasma, and platelet transfusion used to arrest progression of intracranial hemorrhage after traumatic brain injury in a patient taking anticoagulant and antiplatelet agents.
作者信息
Yoshizawa Joe, Namiki Jun, Nishida Yusho, Kaneko Yasushi, Hori Shingo
机构信息
Department of Emergency and Critical Care Medicine Keio University School of Medicine Shinjuku Tokyo Japan.
出版信息
Acute Med Surg. 2016 Apr 26;3(4):392-396. doi: 10.1002/ams2.200. eCollection 2016 Oct.
CASE
An 89-year-old man fell from stairs and sustained head trauma. He was taking warfarin and aspirin. Upon arrival at our hospital, his Glasgow Coma Scale score was 14. Initial head computed tomography showed small acute subdural hematoma. We immediately administered vitamin K and ordered fresh-frozen plasma. Repeat computed tomography 3 and 6 h after trauma revealed the acute subdural hematoma had increased to 14 and 20 mm, respectively, and there were several new intracranial hemorrhages. Fresh-frozen plasma and platelet transfusion were initiated.
OUTCOME
Follow-up computed tomography revealed no further progression of intracranial hemorrhages, and the patient's consciousness did not deteriorate further.
CONCLUSION
Appropriate administration of vitamin K, fresh-frozen plasma, and platelets successfully arrested progression of traumatic intracranial hemorrhages in this patient taking anticoagulant/antiplatelet agents and may have averted brain surgery.
病例
一名89岁男性从楼梯上摔下，头部受伤。他正在服用华法林和阿司匹林。到达我院时，他的格拉斯哥昏迷量表评分为14分。初次头颅计算机断层扫描显示有小的急性硬膜下血肿。我们立即给予维生素K并输注新鲜冰冻血浆。外伤后3小时和6小时复查计算机断层扫描显示急性硬膜下血肿分别增至14毫米和20毫米，并且出现了几处新的颅内出血。开始输注新鲜冰冻血浆和血小板。
结果
随访计算机断层扫描显示颅内出血未进一步进展，患者意识未进一步恶化。
结论
对该服用抗凝/抗血小板药物的患者适当给予维生素K、新鲜冰冻血浆和血小板成功阻止了创伤性颅内出血的进展，可能避免了脑部手术。
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