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題名 | 血漿析離療法引起之凝血異常:一例報告=Plasmapheresis-related Coagulopathy: Report of a Case |
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作者 | 葉建宏; 邱浩彰; 沈幸梅; | 書刊名 | 臺灣醫學 |
卷期 | 3:6 1999.11[民88.11] |
頁次 | 頁679-682 |
分類號 | 415.9413 |
關鍵詞 | 血漿析離術; 雙重過濾血漿析離術; 血漿交換; 凝血異常現象; 併發症; Plasmapheresis; Double filtration plasmapheresis; Plasma exchange; Coagulopathy; Complication; |
語文 | 中文(Chinese) |
中文摘要 | 血漿析離術相關之出血併發症,在文獻中發生率極低。 新光醫院神經科報告一例 重症肌無力病患在接受連續 5 天, 每次一個血漿容積過濾量的雙重過濾血漿析離療法後, 出現凝血異常現象,引起原先中心靜脈穿刺處大量出血,緊急凝血機能試驗發現凝血酵素原 時間( prothrombin time )> 60 秒, 活化部分凝血激素時間( activated partial thromboplastin time )> 120 秒,纖維蛋白原< 70 mg/dL, 遂接受 6 單位新鮮冷凍血 漿輸注及持續患部加壓止血而緩解。文中討論引起此現象之可能成因及因應之道。我們建議 如病人在短時間連續數次之密集血漿析離療法時,必需嚴密監控凝血機能以避免出血之危險 性。 |
英文摘要 | Plasmapheresis-related bleeding is rare. We report a patient with myasthenia gravis who experienced hemorrhage from the puncture site used to insert a central vein catheter, after only five sessions of double filtration plasmapheresis. Hematologic survey showed markedly prolonged prothrombin time (>60 sec.) and activated partial thromboplastin time (>120 sec.) and an extremely low level of serum fibrinogen (<70 mg/dL), but a normal thrombocyte count. Under the diagnosis of plasmapheresis-related coagulopathy, 6 units of fresh frozen plasma was transfused to stop the bleeding. No further hemorrhagic complications were noted. We suggest coagulation function should be monitored when multiple aphereses are performed over a short period to minimize the risk of hemorrhage. |
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