便携式纤维蛋白原检测设备的价值——一例伴有产科弥散性血管内凝血的严重产后出血病例报告
The value of the portable fibrinogen measuring device-a case report of severe postpartum hemorrhage with obstetric disseminated intravascular coagulation.
作者信息
Hikida Yoko, Sumikura Hiroyuki, Okada Hisako, Fujino Takashi, Tanaka Mayumi, Sakai Yu, Okahara Shoko, Inoue Rie
机构信息
Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
出版信息
JA Clin Rep. 2021 Mar 9;7(1):23. doi: 10.1186/s40981-021-00426-y.
BACKGROUND
Fibrinogen concentration is an important indicator of the treatment for obstetric disseminated intravascular coagulation (DIC). We present how using the fibrinogen measuring device could solve problems in the treatment of postpartum hemorrhage with complicated DIC.
CASE PRESENTATION
A 32-year-old woman with monochorionic diamniotic twins at 22 weeks of pregnancy was diagnosed with placental abruption and underwent emergent cesarean section. The estimated blood loss was 8375 g. She was transferred to our hospital for further treatment. Compressive uterine sutures and balloon tamponade were performed. We transfused fibrinogen and fresh frozen plasma actively during the operation to maintain plasma fibrinogen above 200 mg/dL by using a point-of-care fibrinogen measuring device. In spite of massive hemorrhage exceeding 10 L, she was extubated at the end of the operation and discharged on the 7th day after the operation.
CONCLUSION
The portable fibrinogen measuring device was useful for point-of-care assessment of obstetric DIC.
背景
纤维蛋白原浓度是产科弥散性血管内凝血（DIC）治疗的重要指标。我们展示了使用纤维蛋白原测量设备如何解决产后出血合并DIC治疗中的问题。
病例介绍
一名32岁妊娠22周的单绒毛膜双羊膜囊双胎孕妇被诊断为胎盘早剥并接受了急诊剖宫产。估计失血量为8375克。她被转至我院进一步治疗。进行了子宫压迫缝合和球囊填塞。术中我们通过使用即时检测纤维蛋白原测量设备积极输注纤维蛋白原和新鲜冰冻血浆，以维持血浆纤维蛋白原水平高于200mg/dL。尽管出血超过10升，她在手术结束时拔管，并于术后第7天出院。
结论
便携式纤维蛋白原测量设备有助于对产科DIC进行即时检测评估。
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