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臨床婦人科産科77巻5号

2023年05月発行

文献概要

今月の臨床 産科救急―意識障害と危機的出血の初期対応 産科危機的出血への対応

緊急輸血・血液製剤投与

著者: 松永茂剛1

所属機関: 1埼玉医科大学総合医療センター産婦人科

ページ範囲:P.488 - P.494

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●大量輸血の予測因子として最も優れたパラメータはフィブリノゲン値である.

●フィブリノゲン測定については,POCTを用いて迅速に測定できるようになってきている.

●フィブリノゲン製剤の保険適用により速やかなフィブリノゲン補充が可能となってきており,patient blood managementに基づいた輸血療法が実施可能となりつつある.

参考文献

1)日本産婦人科医会妊産婦死亡症例検討評価委員会:母体安全への提言2020,vol. 11.2021年9月
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4)日本産科婦人科学会,他:産科危機的出血への対応指針2022.2022
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13)厚生労働省食品局血液対策課:血液製剤の使用指針,改定版.2005年9月
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15)Borgman MA, et al : The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma 63 : 805-813, 2007
16)Matsunaga S, et al : The clinical efficacy of fibrinogen concentrate in massive obstetric haemorrhage with hypofibrinogenaemia. Sci Rep 7 : 46749, 2017
17)The L:WOMAN : reducing maternal deaths with tranexamic acid. Lancet 389 : 2081, 2017
18)Ker K, et al : Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev 5 : CD004896, 2015
19)CRASH-2 trial collaborators;et al : Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage(CRASH-2): a randomised, placebo-controlled trial. Lancet 376 : 23-32, 2010

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1294

印刷版ISSN:0386-9865

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