Yoshikawa Sachio, Kumano Isao, Satoh Yasushi, Yufune Shinya
Department of Anesthesiology, Japan Self Defense Forces Hospital Yokosuka, 1766-1 Tauraminatocho, Yokosuka, Kanagawa 237-0071 Japan.
Department of Surgery, Japan Self Defense Forces Hospital Yokosuka, 1766-1 Tauraminatocho, Yokosuka, Kanagawa 237-0071 Japan.
JA Clin Rep. 2016;2(1):17. doi: 10.1186/s40981-016-0047-4. Epub 2016 Aug 8.
Factor XI deficiency is rare but may cause life-threatening bleeding during the perioperative period. The clinical manifestation of factor XI deficiency is characterized by bleeding tendency. This unpredictable bleeding tendency makes anesthetic management difficult. We report a case of a partial duodenectomy in a patient with factor XI deficiency. The patient was scheduled for duodenectomy because of a duodenal tumor. When checked for coagulation before surgery, the patient was found to have a remarkably prolonged activated partial thrombin time, and further investigation revealed factor XI deficiency. Fresh frozen plasma was transfused before surgery, and general anesthesia and peripheral nerve block were performed. In the present case of factor XI deficiency, supplementation with clotting factor and proper anesthetic management were important to prevent severe complications.
因子 XI 缺乏症罕见,但在围手术期可能导致危及生命的出血。因子 XI 缺乏症的临床表现以出血倾向为特征。这种不可预测的出血倾向使麻醉管理变得困难。我们报告一例因子 XI 缺乏症患者行部分十二指肠切除术的病例。该患者因十二指肠肿瘤而计划接受十二指肠切除术。术前检查凝血功能时,发现患者活化部分凝血活酶时间显著延长,进一步检查发现因子 XI 缺乏。术前输注了新鲜冰冻血浆,并实施了全身麻醉和外周神经阻滞。在本因子 XI 缺乏症病例中,补充凝血因子和适当的麻醉管理对于预防严重并发症很重要。