Scott T A, Jackler R K, Koerper M A
Department of Otolaryngology, University of California, San Francisco 94117.
Arch Otolaryngol Head Neck Surg. 1988 Dec;114(12):1445-8. doi: 10.1001/archotol.1988.01860240095031.
Hemophiliacs are well known to be among the high-risk groups for acquiring acquired immunodeficiency syndrome due to their frequent exposure to pooled blood products. We reviewed our recent experience involving hemophiliacs undergoing a variety of otolaryngologic surgical procedures. A protocol was developed to minimize the risks of hemorrhage through the judicious use of preoperative and post-operative coagulation replacement products. Modern hemostatic techniques, such as the use of the surgical laser, also had a role in lessening the incidence of bleeding problems. The relative risks of the various hemostatic products with regard to the transmission of communicable diseases such as acquired immunodeficiency syndrome and hepatitis were evaluated. Recent data suggest that heat treatment of factors VIII and IX concentrates eliminates the risk of acquired immunodeficiency syndrome transmission, and these heated concentrates should be used in preference to older products. Hepatitis remains a problem, but this risk may be reduced to some degree through immunization with hepatitis B vaccines that have recently been proved safe and effective.
血友病患者因频繁接触混合血液制品，众所周知属于感染获得性免疫缺陷综合征的高危人群。我们回顾了近期涉及接受各种耳鼻喉科手术的血友病患者的经验。制定了一项方案，通过合理使用术前和术后凝血替代产品来尽量降低出血风险。现代止血技术，如使用外科激光，在减少出血问题发生率方面也发挥了作用。评估了各种止血产品在传播获得性免疫缺陷综合征和肝炎等传染病方面的相对风险。最新数据表明，对 VIII 因子和 IX 因子浓缩物进行热处理可消除传播获得性免疫缺陷综合征的风险，应优先使用这些经过加热的浓缩物而非旧产品。肝炎仍然是一个问题，但通过接种最近已被证明安全有效的乙肝疫苗，这一风险可能会在一定程度上降低。
