原发性低纤维蛋白原血症合并子宫肌瘤1例
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摘要
<正>患者,49岁,因"阴道流血10 d,加重3 d"于2018年6月14日入院。患者10 d前进入月经期,但经期明显延长,近3 d阴道流血加重,2 d前自行口服孕酮治疗,症状未见缓解。既往有输血史,无肝炎病史。入院查体:生命体征平稳,结膜苍白,周身皮肤无出血点,皮肤、巩膜无黄染,颈部对称,浅表淋巴结未触及肿大。胸廓对称无畸形,双肺呼吸音清,未闻干湿啰音;心律齐,无病理性杂音。肝脾未触及,双下肢无水肿。外院查凝血功能:Fib 0.61 g/L, TT 34.7 s。妇科门诊彩色超声报告:子宫内膜欠均,多发子宫肌瘤(合并子宫腺肌病),宫颈回声欠
引文
[1] Yasunaga H. Risk of authoritarianism:fibrinogen-transmitted hepatitis C in Japan[J]. Lancet, 2007,370(9604):2063-2067. DOI:10.1016/s0140-6736(07)61867-4.
[2] Martini WZ, Dubick MA. Fibrinogen concentrate administration inhibits endogenous fibrinogen synthesis in pigs after traumatic hemorrhage[J]. J Trauma Acute Care Surg,2015,79(4):540-547. DOI:10. 1097/TA. 0000000000000819.
[3] Harr JN. Moore EF, Ghasabyan A, et al. Functional fibrinogen assay indicates that fibrinogen is critical in correcting abnormal clot strength following trauma[J]. Shock, 2013,39(1):45-49. DOI:10. 1097/SHK. Ob013e3182787122.
[4] Wafaisade A, Lefering R, Maegele M, et al. Administration of fibrinogen concentrate in exsanguinating trauma patients is associated with improved survival at 6 hours but not at discharge[J]. J Trauma Acute Care Surg, 2013, 74(2):387-383. DOI:10. 1097/TA.0b013e31827e2410.
[5]Aubron C, Reade MC, Fraser JF, et al. Efficacy and safety of fibrinogen concentrate in trauma patients-a systematic review[J]. J Crit Care, 2014,29(3):471. e11-7. DOI:10. 1016/j. jcrc. 2013.12.011.
[6] Levy JH, Welsby I, Goodnough LT. Fibrinogen as a therapeutic target for bleeding:a review of critical levels and replacement therapy[J]. Transfusion, 2014,54(5):1389-1405. DOI:10. 1111/ttf.12431.
[7] Dear A, Brennan SO, Sheat MJ, et al. Acquired dysfibrinogenemia caused by monoclonal production of immunoglobulinλlight chain[J]. Haematologica. 2007,92(11):e111-e117. DOI:10. 3324/haematol. 11837.
[8] Leal-Noval SR, Casado M, Arellano-Orden V, et al. Administration of fibrinogen concentrate for refractory bleeding in massively transfused,non-trauma patients with coagulopathy:a retrospective study with comparator group[J]. BMC Anesthesiol, 2014,14:109. DOI:10.1186/1471-2253-14-109.
[9] Mallaiah S, Barclay P, Harrod I,et al. Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage[J]. Anaesthesia, 2015,70(2):166-175. DOI:10. 1111/anae. 12859.
[2] Martini WZ, Dubick MA. Fibrinogen concentrate administration inhibits endogenous fibrinogen synthesis in pigs after traumatic hemorrhage[J]. J Trauma Acute Care Surg,2015,79(4):540-547. DOI:10. 1097/TA. 0000000000000819.
[3] Harr JN. Moore EF, Ghasabyan A, et al. Functional fibrinogen assay indicates that fibrinogen is critical in correcting abnormal clot strength following trauma[J]. Shock, 2013,39(1):45-49. DOI:10. 1097/SHK. Ob013e3182787122.
[4] Wafaisade A, Lefering R, Maegele M, et al. Administration of fibrinogen concentrate in exsanguinating trauma patients is associated with improved survival at 6 hours but not at discharge[J]. J Trauma Acute Care Surg, 2013, 74(2):387-383. DOI:10. 1097/TA.0b013e31827e2410.
[5]Aubron C, Reade MC, Fraser JF, et al. Efficacy and safety of fibrinogen concentrate in trauma patients-a systematic review[J]. J Crit Care, 2014,29(3):471. e11-7. DOI:10. 1016/j. jcrc. 2013.12.011.
[6] Levy JH, Welsby I, Goodnough LT. Fibrinogen as a therapeutic target for bleeding:a review of critical levels and replacement therapy[J]. Transfusion, 2014,54(5):1389-1405. DOI:10. 1111/ttf.12431.
[7] Dear A, Brennan SO, Sheat MJ, et al. Acquired dysfibrinogenemia caused by monoclonal production of immunoglobulinλlight chain[J]. Haematologica. 2007,92(11):e111-e117. DOI:10. 3324/haematol. 11837.
[8] Leal-Noval SR, Casado M, Arellano-Orden V, et al. Administration of fibrinogen concentrate for refractory bleeding in massively transfused,non-trauma patients with coagulopathy:a retrospective study with comparator group[J]. BMC Anesthesiol, 2014,14:109. DOI:10.1186/1471-2253-14-109.
[9] Mallaiah S, Barclay P, Harrod I,et al. Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage[J]. Anaesthesia, 2015,70(2):166-175. DOI:10. 1111/anae. 12859.