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首页> 外文期刊>Experimental and therapeutic medicine >Hyperfibrinolysis after parapelvic cyst surgery: A case report
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Hyperfibrinolysis after parapelvic cyst surgery: A case report

机译：骨盆旁囊肿手术后高纤蛋白溶解：一例报告

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摘要

The present study describes the diagnosis and treatment of hyperfibrinolysis following surgery in a 25-year-old female patient. An examination revealed that the left kidney had been affected by severe hydronephrosis for two weeks prior to hospitalization. The diagnosis of a parapelvic cyst was obtained by preoperative intravenous pyelogram (IVP), computed tomography (CT) and upper left urinary tract retrograde pyelography. Unroofing of the left parapelvic cyst was performed by open surgery. The patient exhibited symptoms of shock 48 h later, and her hemoglobin (Hb) levels dropped to only 62.2 g/l. To treat this, 400 ml erythrocyte suspension transfusion was administered 3 times every other day. The patient's Hb levels remained between 50 and 60 g/l. The D-dimer assay index rose from 0.3 to 16 mg/l and the fibrin degradation product (FDP) levels progressively increased following the hemorrhage, while the platelet count, prothrombin time (VU), activated partial thromboplastin time (APTT) and fibrinogen (Fg) index were all within normal levels. p-Aminomethylbenzoic acid (PAMBA; 0.5 g) was administered to the patient every day, and as a consequence the Hb levels rose steadily from the next day onwards. After a one week course of PAMBA treatment, the patient's condition became stable. Blood coagulation and fibrinolytic function measurements were all within the normal ranges in the three months following the surgery. Delayed hemorrhage following surgery should be considered as a possible cause of hyperfibrinolysis. Monitoring FDP and D-dimer levels may aid a rapid and clear diagnosis. Anti-fibrinolytic therapy, such as PAMBA treatment, is safe and effective for use against the type of hemorrhage caused by hyperfibrinolysis.
机译：本研究描述了一名25岁女性患者手术后过度纤溶的诊断和治疗。一项检查显示，住院前两周左肾受到严重肾积水的影响。术前静脉肾盂造影（IVP），计算机断层扫描（CT）和左上尿路逆行肾盂造影可诊断为盆腔旁囊肿。左骨盆旁囊肿的房顶切除术是通过开放手术进行的。患者在48小时后出现休克症状，其血红蛋白（Hb）水平降至仅62.2 g / l。为了治疗这种情况，每隔一天进行3次400毫升红细胞悬液输注。患者的血红蛋白水平保持在50至60克/升之间。 D-二聚体测定指数从0.3毫克/升升至16毫克/升，出血后血纤蛋白降解产物（FDP）水平逐渐升高，而血小板计数，凝血酶原时间（VU），活化部分凝血活酶时间（APTT）和纤维蛋白原（ Fg）指数均在正常水平之内。每天给患者服用对氨基甲基苯甲酸（PAMBA; 0.5 g），因此从第二天开始，血红蛋白水平稳定上升。经过一个星期的PAMBA治疗，患者的病情稳定。手术后三个月内的凝血和纤溶功能测量均在正常范围内。手术后延迟出血应被认为是过度纤维蛋白溶解的可能原因。监测FDP和D-二聚体水平可能有助于快速明确的诊断。抗纤维蛋白溶解疗法（例如PAMBA治疗）可安全有效地用于治疗因高纤维蛋白溶解引起的出血类型。

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