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.
ABSTRACT
【Objective】 To investigate the factors affecting the quality of cryoprecipitated antihemophilic factor. 【Methods】 The quality test results of cryoprecipitated antihemophilic factor in Xuzhou Central Blood Station from 2017 to 2020 were selected and compared. The fresh frozen plasma (FFP) was stratifying by storage time following whole blood collection: less than 2h, 2~4 h, 4~6 h, and 6~8 h; by gender: males and females; by blood group: A, B, O, and AB groups; by age: 18~30, 30~45, and 45~60 ages; by preparation method: centrifugation and siphonage. The contents of fibrinogen (FIB) and factor Ⅷ in cryoprecipitated antihemophilic factor in each group were compared. 【Results】 The content of FIB and factor Ⅷ in females were higher than those in males(P<0.05). The content of factor Ⅷ differed statically by blood groups (P<0.05), which was lower in group O than others [graup A(180.5±75.2)IU, graup B(155.1±59.4)IU, graup O(109.3±46.4)IU, graup AB(168.5±65.1)IU]. The content of factor Ⅷ increased with age statistically (P<0.05). The content of FIB prepared by centrifugation [(373.3±126.1)mg] was superior to siphonage [(309.4±85.6)mg] (P<0.05), while the content of factor Ⅷ prepared by siphonage [(172.4±71.3)IU] was superior to centrifugation [(124.0±49.1)mg] (P<0.05). 【Conclusion】 Gender and preparation method are the influencing factors of FIB. Gender, age, blood group and preparation method are the influencing factors of the content of factor Ⅷ. The FFP prepared by whole blood preserved with the ACD (citrate, sodium citrate and glucose) solution at any time within 8h after the collection has no impact on the quality of cryoprecipitated antihemophilic factor.