Barczewska M
Katedry i Kliniki Neurochirurgii AM, Warszawie.
Neurol Neurochir Pol. 1997 Mar-Apr;31(2):271-80.
Intraoperative haemorrhage or major bleeding may still cause serious problem in present-day neurosurgery, especially with reference to major vascular procedures despite the improving surgical techniques and methods of performing bloodless procedures. This is why certain neurosurgical procedures are not attempted without prior preparation of a major amount of blood. Jehovah's Witnesses refuse their consent to be subjected to blood transfusion of their own or foreign blood despite their full awareness of a potential danger to their lives. This paper describes three patients subjected to the major vascular intracranial procedures (two cases of clipping intracranial aneurysms, and one case of removal of arteriovenous intracranial angioma in anaemic patient), and one case of endovascular neuroradiosurgical procedure in intracranial aneurysm. This last method is presented as alternative procedure to decrease complications that are related to bloodless interventions suggest certain management methods which may decrease the surgical risk. One of those methods erythropoietin in treatment of postoperative anaemia and in preparing anaemic patients to vascular intracranial procedures.
在当今神经外科手术中，术中出血或大出血仍然可能引发严重问题，尤其是在进行大型血管手术时，尽管手术技术和实施无血手术的方法有所改进。这就是为什么在没有预先准备大量血液的情况下，某些神经外科手术不会贸然尝试。耶和华见证人尽管充分意识到自身生命存在潜在危险，但仍拒绝同意接受自身或异体输血。本文描述了3例接受颅内大型血管手术的患者（2例颅内动脉瘤夹闭术，1例贫血患者的颅内动静脉血管瘤切除术），以及1例颅内动脉瘤的血管内神经放射外科手术。最后这种方法作为一种替代手术被提出，以减少与无血干预相关的并发症，并提出了某些可能降低手术风险的管理方法。其中一种方法是使用促红细胞生成素治疗术后贫血，并使贫血患者为颅内血管手术做好准备。
