Perioperative blood management of a patient with coagulation factor Ⅴ deficiency and literature review
10.13303/j.cjbt.issn.1004-549x.2023.11.021
- VernacularTitle:凝血因子Ⅴ缺乏症患者的围手术期血液管理并文献复习
- Author:
Ronghui SHI
1
;
Qiang MENG
2
;
Jianjun WU
1
;
Lan YANG
1
;
Xiaoqiong LONG
1
;
Li ZHANG
1
;
Shuming ZHAO
1
Author Information
1. Department of Blood Transfusion, Guiqian International General Hospital, Guiyang 550018, China
2. Department of Clinical Laboratory, Guiqian International General Hospital, Guiyang 550018, China
- Publication Type:Journal Article
- Keywords:
coagulation factor Ⅴ deficiency;
cryoprecipitated antihemophilic factor;
fresh frozen plasma (FFP);
thrombelastogram (TEG)
- From:
Chinese Journal of Blood Transfusion
2023;36(11):1057-1060
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the perioperative blood management in patients with pancreatic pseudocyst combiend with coagulation factor Ⅴ(FⅤ) deficiency. 【Methods】 Preoperative: In order to determine the effect of cryoprecipitated antihemophilic factor and fresh frozen plasma (FFP) on the elevation level of factor Ⅴ, we alternately infused cryoprecipitate and FFP in the resting state. TEG, coagulation function and coagulation factor activity were monitored before and 1 h, 24 h and 48 h after infusion, and intraoperative and postoperative blood transfusion strategies were formulated. FFP 600 mL and cryoprecipitate 10 U were supplemented preoperatively. Intraoperative: The operation procedure was performed for 7 hours with an infusion of 600 mL FFP without significant bleeding. Postoperative: FFP was infused. 【Results】 Preoperative: The coagulation factor Ⅴ activity on pre-operation was 1.9% and 1.8%. After alternating infusion cryoprecipitate 10 U and FFP 1 200 mL, the FⅤactivity increased to 5.1% and 6.0%, respectively. There was no significant difference in TEG parameters, PT and ATPP results were decreased to varying degrees. Intraoperative: The operation was successful without obvious bleeding. Postoperative: FFP 500 mL was infused 2 h after operation, and FFP 250-500 mL was injected daily from 1 to 7 days after surgery. No significant bleeding was observed in the wound, the results of TEG, PT, APTT and hemoglobin (Hb) did not change significantly compared with those before surgery. The patient was discharged successfully 12 days after surgery. The genetic test results showed that he had inherited coagulation factor Ⅴ deficiency, which was a compound heterozygous variation. 【Conclusion】 Perioperative blood management in patients with FⅤ deficiency combined with surgical disease, requiring pre-transfusion evaluation and post-transfusion evaluation in combination with laboratory investigations and clinical manifestations, cryoprecipitate and fresh frozen plasma can be effective in supplementing coagulation factors. The TEG seems to be better than the Seven items of coagulation function in judging the clotting status of patients with FⅤ deficiency.
