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纤维溶解潜力作为产后出血的危险因素
Daniel Gruneberg1, Paula Braun1, Herbert Schöchl2
1Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.
Frontiers in medicine
|September 25, 2023
概括
甚至在分娩前,在患有严重产后出血 (PPH) 的妇女中观察到过高的纤维溶解潜力. 虽然是凝血病的危险因素,但单独的高纤维溶解潜力并不总是导致PPH.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 临界护理医学 临界护理医学
背景情况:
- 在全球范围内,产后出血 (PPH) 仍然是孕产妇死亡的主要原因.
- 损坏的纤维素聚合因涉及到PPH,但目前的粘弹性测量很难检测出早期纤维素解变化.
- 护理点粘弹性测试 (POC-VET) 提供了敏感纤维解质评估的潜力.
研究的目的:
- 评估在分娩期间患有PPH的妇女的POC-VET纤维溶解潜力的变化.
- 确定纤维溶解潜力是否有助于预测和治疗PPH.
主要方法:
- 来自217名分娩妇女的全血样本在入院时被分析,在胎盘分离后30-60分钟,以及分娩后.
- 使用ClotPro系统进行的治疗点粘弹性测试 (POC-VET),包括TPA测试溶解时间,评估了纤维溶解潜力.
- 标准实验室测试,聚合计和凝血因子测量与失血和临床结果相关.
主要成果:
- 患有严重PPH的女性在入院时表现出增加的纤维解质潜力,持续的胎盘分离后.
- 较高的纤维解质潜力与较大的纤维素降落和较高的d-二次体水平相关.
- 70%的严重PPH病例显示出高纤维溶解潜力,而非PPH病例中这一比例为54%.
结论:
- 在患有严重PPH的妇女中,产前和产周纤维素分析潜力升高.
- 高纤维溶解潜力是凝血病的危险因素,但需要额外的条件才能表现为PPH.
- POC-VET可能会提供有关纤维素分解的见解,但需要进一步的研究才能充分理解其在PPH管理中的作用.
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