PDF(Pubmed)
Abstract：
Reports on cases of factor Ⅴ (FⅤ) deficiency complicated by platelet function disorders in patients undergoing cardiac surgery are rare, and the utilization of thromboelastography in such cases is limited. This case presents a unique case of FⅤ deficiency complicated by platelet function disorders, highlighting the significance of tailored transfusion strategies guided by thromboelastography (TEG). A 64-year-old hemodialysis patient who was diagnosed with FⅤ deficiency 24 years prior presented for an on-pump coronary artery bypass graft. The decrease in FⅤ activity on preoperative examination was mild. Based on this finding, it was determined that preoperative fresh frozen plasma supplementation was not required. However, the case was complicated by platelet function disorders; therefore, a preoperative transfusion of platelet concentrate was performed to correct the decreased platelet function, enabling subsequent surgery. Intraoperative and postoperative transfusion strategies were guided by TEG. This study highlights TEG-guided transfusion management as a viable option for patients with FⅤ deficiency complicated by platelet function disorders.
摘要：
心脏手术患者凝血因子Ⅴ(FⅤ)缺乏并发血小板功能紊乱的病例报道较少,在这种情况下，血栓弹力图的应用是有限的。本病例为一例FⅤ缺乏并发血小板功能紊乱的独特病例,强调在血栓弹力图（TEG）指导下量身定制的输血策略的重要性。一名64岁的血液透析患者，在24年前被诊断为FV缺乏症，接受了体外循环冠状动脉搭桥术。术前检查时FⅤ活性下降较轻。基于这一发现,确定术前不需要补充新鲜冰冻血浆.然而,该病例并发血小板功能紊乱；因此，术前输注血小板浓缩物以纠正降低的血小板功能，能够进行后续手术。TEG指导术中和术后输血策略。这项研究强调了TEG指导的输血管理是FⅤ缺乏症并发血小板功能紊乱患者的可行选择。
