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一名有获得性血友病病史的中年男子拔牙后出现致命情况：采用外科气管切开术并使用新鲜冰冻血浆和冷沉淀以确保气道通畅。

Fatal scenario following dental extraction in middle-aged man with history of acquired hemophilia: Employment of surgical tracheostomy and use of FFP and cryoprecipitate to gain patent airway.

作者信息

Bhatta Sunil, Pandit Sukriti, Nepal Sabin, Chaudhary Pratik

机构信息

Department of Anesthesia and Critical Care Nisarga Hospital and Research Centre Pvt. Ltd Dhangadhi Nepal.

Department of Radiodiagnosis and Imaging Nisarga Hospital and Research Centre Pvt. Ltd Dhangadhi Nepal.

出版信息

Clin Case Rep. 2024 Aug 30;12(9):e9411. doi: 10.1002/ccr3.9411. eCollection 2024 Sep.

DOI:10.1002/ccr3.9411
PMID:39219776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11364584/
Abstract

Acquired hemophilia A can upshot in a life-threatening hemorrhage and airway obstruction. Airway bleeding is a weighty emergency in hemophilia care, necessitating the immediate start of effective hemostatic therapy (porcine factor VIII, the factor eight inhibitor bypassing activity and recombinant factor VIIa) and the decision to undertake proper airway control, such as tracheal intubation and tracheostomy. However, due to the dearth deficiency of effective hemostatic measures we relied upon the use of fresh frozen plasma and cryoprecipitate to gain control of the bleeding despite the precarious threat of infectious disease transmission associated with their use.

摘要

获得性血友病A可导致危及生命的出血和气道梗阻。气道出血是血友病治疗中的严重紧急情况，需要立即开始有效的止血治疗（猪源凝血因子VIII、凝血因子VIII抑制剂旁路活性药物和重组凝血因子VIIa），并决定采取适当的气道控制措施，如气管插管和气管切开术。然而，由于缺乏有效的止血措施，尽管使用新鲜冰冻血浆和冷沉淀存在传染病传播的危险威胁，但我们仍依靠它们来控制出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/5f3e845670b7/CCR3-12-e9411-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/dcc4eb0df109/CCR3-12-e9411-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/94ad5bf268df/CCR3-12-e9411-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/f5cdefc789d6/CCR3-12-e9411-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/42d5d66274f3/CCR3-12-e9411-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/5f3e845670b7/CCR3-12-e9411-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/dcc4eb0df109/CCR3-12-e9411-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/94ad5bf268df/CCR3-12-e9411-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/f5cdefc789d6/CCR3-12-e9411-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/42d5d66274f3/CCR3-12-e9411-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c0/11364584/5f3e845670b7/CCR3-12-e9411-g005.jpg

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本文引用的文献

1
Uncontrolled Bleeding After Tongue Laceration Leading to a Difficult Airway in the Setting of Hemophilia A: A Case Report.甲型血友病患者舌部裂伤后出血失控导致气道困难：一例报告
Cureus. 2022 Nov 13;14(11):e31455. doi: 10.7759/cureus.31455. eCollection 2022 Nov.
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Acquired hemophilia A that required surgical hemostasis of hematomas occupying oral cavity: a case report.需要对占据口腔的血肿进行手术止血的获得性甲型血友病：一例报告。
J Med Case Rep. 2021 Feb 15;15(1):66. doi: 10.1186/s13256-021-02669-w.
3
Ultrasound guided percutaneous dilatation tracheotomy (US-PDT) to prevent potentially life-threatening complications: A case report.
超声引导下经皮扩张气管切开术（US-PDT）预防潜在危及生命的并发症：一例报告。
Int J Surg Case Rep. 2020;77S(Suppl):S125-S128. doi: 10.1016/j.ijscr.2020.09.031. Epub 2020 Sep 12.
4
Life-Threatening Tongue and Retropharyngeal Hemorrhage in a Patient with Hemophilia A with Inhibitors.一名患有血友病A且产生抑制剂的患者出现危及生命的舌部和咽后出血。
Am J Case Rep. 2019 Jul 15;20:1022-1026. doi: 10.12659/AJCR.916151.
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Acquired factor VIII deficiency presenting as a floor of the mouth swelling.以口腔底部肿胀为表现的获得性因子 VIII 缺乏症。
BMJ Case Rep. 2011 Aug 4;2011:bcr0520114235. doi: 10.1136/bcr.05.2011.4235.
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Asphyxia following Dental Extraction in a Haemophiliac.血友病患者拔牙后窒息
Br Med J. 1942 Jul 11;2(4253):34-5. doi: 10.1136/bmj.2.4253.34.
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[Compressive retropharyngeal hematoma in a hemophiliac patient].[血友病患者的压缩性咽后血肿]
Rev Stomatol Chir Maxillofac. 2008 Jun;109(3):187-9. doi: 10.1016/j.stomax.2008.03.004. Epub 2008 May 27.
8
A case of acute upper and lower airway obstruction due to retropharyngeal haemorrhage secondary to acquired haemophilia A.1例继发于获得性血友病A的咽后出血导致急性上、下气道梗阻的病例。
Anaesthesia. 2007 Jun;62(6):627-30. doi: 10.1111/j.1365-2044.2007.05053.x.
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Death from respiratory obstruction in haemophilia.血友病患者因呼吸道阻塞致死
Med J Aust. 1951 Feb 10;1(6):227-8. doi: 10.5694/j.1326-5377.1951.tb55635.x.
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Haemophilia with respiratory obstruction.血友病伴呼吸阻塞。
Br Med J. 1953 May 23;1(4820):1144-6. doi: 10.1136/bmj.1.4820.1144.