抗磷脂综合征患者心脏瓣膜手术期间活化凝血时间监测与肝素浓度测量的相关性：一例报告
Correlation between activated clotting time monitoring and heparin concentration measurement in a patient with antiphospholipid syndrome during cardiac valve surgery: a case report.
作者信息
Yoshinaga Koichi, Otsuka Yuji, Furukawa Taku, Amitani Shizuka, Kimura Naoyuki, Sanui Masamitsu
机构信息
Department of Anesthesiology and Critical Care, Jichi Medical University Saitama Medical Center, 1-847, Amanumacho, Omiya-ku, Saitama-city, Saitama, 330-8503, Japan.
Department of Cardiovascular Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan.
出版信息
JA Clin Rep. 2021 Mar 14;7(1):24. doi: 10.1186/s40981-021-00427-x.
BACKGROUND
Anticoagulation management of patients with antiphospholipid syndrome (APS) undergoing cardiac surgery is challenging due to the prolongation of activated clotting time (ACT). Currently, no study has compared the utility of ACT monitoring using the Hemochron Jr. Signature+ and that of heparin concentration management using the Hemostasis Management System (HMS) Plus in patients with APS.
CASE PRESENTATION
A 71-year-old woman with APS was scheduled to undergo an aortic valve replacement for aortic regurgitation. The ACT was measured using the Hemochron Jr. Signature+, and the heparin concentration was measured concurrently using the HMS Plus. ACT over 480 s corresponded to an adequate heparin concentration during cardiopulmonary bypass. The clinical course was uneventful, and no thrombotic or hemorrhagic complications were observed.
CONCLUSION
In the present patient with APS, the Hemochron Jr. Signature+ was useful as an anticoagulation management during cardiac valve surgery.
背景
抗磷脂综合征（APS）患者在心脏手术期间的抗凝管理具有挑战性，因为活化凝血时间（ACT）会延长。目前，尚无研究比较使用Hemochron Jr. Signature+监测ACT与使用止血管理系统（HMS）Plus管理肝素浓度在APS患者中的效用。
病例报告
一名71岁患有APS的女性计划接受主动脉瓣置换术以治疗主动脉瓣反流。使用Hemochron Jr. Signature+测量ACT，并同时使用HMS Plus测量肝素浓度。在体外循环期间，ACT超过480秒对应于足够的肝素浓度。临床过程平稳，未观察到血栓形成或出血并发症。
结论
在本APS患者中，Hemochron Jr. Signature+在心脏瓣膜手术期间作为抗凝管理是有用的。
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