臨床婦人科産科73巻9号

2019年09月発行

今月の臨床 産科危機的出血のベストマネジメント―知っておくべき最新の対応策

緊急対処法

フィブリノゲン療法の実際と現状

著者： 関博之¹

所属機関： ¹埼玉医科大学総合医療センター総合周産期母子医療センター

ページ範囲：P.840 - P.845

文献概要

●フィブリノゲンは産科危機的出血，特に消費性凝固障害における母児双方の病態評価に有用なパラメータであると同時に，補充すべき最も重要な凝固因子である．

●産科危機的出血は凝固因子の枯渇が起こりやすい．他の凝固因子は血中濃度が20〜25％以下にならないと凝固障害を起こさないが，フィブリノゲンは40〜50％以下になると凝固障害を起こす．

●出血の原因疾患が消費性凝固障害の場合は，新鮮凍結血漿（FFP）のみで凝固因子を補充しようとすると，肺水腫などの合併症を起こしやすい．そのような場合は，フィブリノゲン製剤が有効である．

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