腹主动脉瘤经积极矫正治疗后仍有持续和反弹凝血功能障碍1例

Hock Peng Koh, Szu Lynn Tay, Shazwani Zulkifli, Muhammad Syafiq Idris, Hanif Hussien
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引用次数: 0

摘要

腹主动脉瘤(AAA)引起凝血功能障碍并不罕见。AAA破裂患者使用华法林会使手术干预的准备工作进一步复杂化,影响预后。我们报告了一例即将破裂的AAA,在华法林使用者中发展为包含泄漏的AAA,尽管使用新鲜冷冻血浆(FFP)和三因子凝血酶原复合物浓缩物(3F-PCC)进行积极纠正,但国际标准化比率(INR)持续升高和反弹。AAA患者可能出现持续和反弹的凝血功能障碍。仅使用FFP或3F-PCC进行矫正治疗并不一定能保证AAA患者凝血功能障碍的成功逆转。一些病例,特别是那些最初矫正治疗失败的病例,需要更积极地联合使用维生素k进行逆转。本病例描述了AAA患者的凝血功能障碍,使用抗凝逆转药物,并强调了严格监测凝血功能在AAA治疗中的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abdominal Aortic Aneurysm with Persistent and Rebound Coagulopathy Despite Aggressive Corrective Treatment: A Case Report
Abdominal aortic aneurysm (AAA) is not uncommon to cause coagulopathy. Warfarin use in patients presented with ruptured AAA can further complicate the preparation for surgical intervention and affect prognosis. We reported a case of impending rupture AAA that progressed to contained leak AAA in a warfarin user, with persistent elevated and rebound international normalized ratio (INR) despite aggressive correction with fresh frozen plasma (FFP) and three-factor prothrombin complex concentrate (3F-PCC). Persistent and rebound coagulopathy is possible in AAA. Corrective treatment with FFP or 3F-PCC alone does not always guarantee the successful reversal of coagulopathy in AAA. Some cases, especially those that failed the initial corrective treatment, require more aggressive reversal with co-administration of vitamin K. This case described coagulopathy in AAA, anticoagulation reversal agents used and emphasized the importance of rigorous coagulation profile monitoring in managing AAA.
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