肝功能障碍患者的严重低血压输血反应:一个病例报告
Priya Prasad1, Jeeva George2, Jijo Joseph Joseph3
1Department of Transfusion Medicine, Caritas Hospital & Institute of Health Sciences, Kottayam, India.
Transfusion medicine (Oxford, England)
|November 24, 2025
概括
低压输血反应 (HyTRs) 在大规模输血协议 (MTPs) 期间可能发生. 这一案例突显了布拉迪基宁介导的HyTRs在新鲜冷等离子体 (FFP) 输血期间在肝功能障碍患者中.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 胃肠病学 胃肠病学
背景情况:
- 大规模输血协议 (MTP) 对于管理严重出血至关重要.
- 与输血相关的并发症,如低血压输血反应 (HyTRs),可能会错过,特别是在肝功能受损的患者中.
研究的目的:
- 报告布拉迪基宁介导的低血压输血反应 (HyTR) 在新鲜冷血 (FFP) 给肝功能障碍患者的病例.
- 强调在肝病患者中识别HyTRs的重要性.
主要方法:
- 一个案例介绍了一名56岁的患有肝硬化和肝转移的妇女,她正在接受需要MTP的手术.
- 患者接受了包装的红细胞,血小板和FFP.
- 在FFP输血后发生了突然的,孤立的低血压,这导致考虑布拉迪基宁介导的HyTR.
主要成果:
- 患者在FFP的第四单元开始后大约5分钟经历了严重的低血压.
- 在停止输血并重新启动血管压缩器后的10分钟内血压恢复正常.
- 由于与FFP的时间关联以及患者的肝功能障碍,怀疑Bradykinin介导的HyTR.
结论:
- 在FFP输血期间识别布拉迪基宁介导的HyTRs很重要,特别是在肝功能障碍患者中.
- 肝脏疾病中布拉迪基宁降解的损害可能会导致HyTRs.
- 及时识别,排除其他原因和支持性护理对于管理HyTRs至关重要.
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