一个因子XIII缺乏症的病例,在桃体切除术后出现复发性术后出血
Takanobu Teramura1, Akihiro Sakai1, Masashi Hamada1
1Department of Otolaryngology, Head and Neck Surgery Tokai University, School of Medicine Isehara Japan.
Clinical case reports
|February 9, 2026
概括
桃体切除术后复发的术后出血可能是罕见的XIII因子缺乏症的信号. 这种情况通常与正常的常规凝血测试一起呈现,需要进一步调查,并立即进行XIII因子缩治疗.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 血液学 血液学 血液学
- 遗传学 遗传学 是一个
背景情况:
- 手术后出血是桃体切除术后的一个常见并发症.
- 虽然经常归因于血液静止不足或血管损伤,但隐性凝血障碍也可能是导致因素.
- 十三因子缺乏症是一种罕见的遗传性出血障碍,由于正常的前列血时间 (PT) 和激活的部分血栓形成时间 (APTT),因此很难在手术前诊断.
研究的目的:
- 强调在桃体切除术后出现复发性术后出血的患者考虑XIII因子缺乏的重要性,特别是当标准凝血测试结果正常时.
- 在这种临床背景下强调XIII因子缺乏的诊断挑战和有效管理.
主要方法:
- 一个27岁的男性患者的病例报告,他因复发性外腹而接受了桃体切除术.
- 术前凝血查包括PT和APTT,显示正常结果.
- 术后监测出血,手术重复干预,以及随后的特定XIII因子活性测试.
主要成果:
- 患者经历了多次的术后出血尽管正常的手术前凝血查.
- 进一步的实验室评估发现XIII因子活性显著降低 (36%).
- 服用XIII因子缩剂有效控制了出血,稳定了患者的病情.
结论:
- 在桃体切除术后出现不明原因的复发性术后出血的情况下,即使常规凝血参数正常,也应该怀疑XIII因子缺乏.
- 通过特定的XIII因子活性测试进行早期诊断和及时启动替代疗法对于预防严重并发症和确保患者的良好结果至关重要.
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