心脏手术中血友病患者的替代疗法：3例报告

陈小坤; 苗齐; 朱铁楠; 张超纪

doi:10.24920/003929

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心脏手术中血友病患者的替代疗法：3例报告

中国医学科学杂志（英文版） 2022年37卷第1期页码：79-81

Case Report | Updated：2024-04-10

- 心脏手术中血友病患者的替代疗法：3例报告
- Affiliations：
  
  1. 1Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2. 2Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  3. 3Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  *E-mail: chaojizhang@163.com.
- Funds：
- DOI：10.24920/003929
  中图分类号：
- 收稿日期：2021-05-07，
  
  录用日期：2021-10-15，
  
  网络出版日期：2022-03-01，
  
  纸质出版日期：2022-03-31
- Accepted：
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陈小坤, 苗齐, 朱铁楠, 等. 心脏手术中血友病患者的替代疗法：3例报告[J]. 中国医学科学杂志（英文版）, 2022,37(1):79-81.

Chen Xiaokun, Miao Qi, Zhu Tienan, et al. Replacement Therapy for Hemophilia Patients Undergoing Cardiac Surgery: Report of Three Cases[J]. Chinese medical sciences journal, 2022, 37(1): 79-81.
陈小坤, 苗齐, 朱铁楠, 等. 心脏手术中血友病患者的替代疗法：3例报告[J]. 中国医学科学杂志（英文版）, 2022,37(1):79-81. DOI： 10.24920/003929.

Chen Xiaokun, Miao Qi, Zhu Tienan, et al. Replacement Therapy for Hemophilia Patients Undergoing Cardiac Surgery: Report of Three Cases[J]. Chinese medical sciences journal, 2022, 37(1): 79-81. DOI： 10.24920/003929.

摘要

血友病是一种X连锁隐性遗传性出血性疾病。近年来随着长效凝血因子及非因子治疗的问世

血友病的诊疗越来越多样化

使得血友病患者的预期寿命得到延长。但血友病患者血液中的凝血因子减少并不会减慢动脉粥样硬化的进展。随着预期寿命的增加

越来越多的血友病患者将患上与年龄相关的心血管疾病

并且将需要外科手术干预。由于心脏手术需要肝素化和体外循环

血友病患者的止血和凝血平衡极具挑战性。本文报告了三例成功接受心脏手术的血友病患者。

Abstract

Hemophilia is an X-linked recessive inherited bleeding disorder. Despite the improved treatment in recent years with the advent of replacement therapies

the progression of atherosclerosis is not slowed down after the reduction of clotting factors in hemophilia. As life expectancy increases

more hemophilia patients will suffer from age-related cardiovascular diseases. Since cardiac surgery needs heparinization and cardiopulmonary bypass (CPB)

it is extremely challenging to balance hemostasis and coagulation in patients with hemophilia. Here we report three cases of hemophilia patients who underwent cardiac surgery successfully.

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references

Lin PS , Yao YT . Perioperative management of hemophilia A patients undergoing cardiac surgery: a literature review of published cases . J Cardiothorac Vasc Anesth 2021 ; 35 ( 5 ): 1341 - 50 . doi: 10.1053/j.jvca.2020.06.074 https://dx.doi.org/10.1053/j.jvca.2020.06.074 . DOI: 10.1053/j.jvca.2020.06.074 http://doi.org/10.1053/j.jvca.2020.06.074 https://linkinghub.elsevier.com/retrieve/pii/S1053077020306182 https://linkinghub.elsevier.com/retrieve/pii/S1053077020306182

Kanellopoulou T , Nomikou E . Replacement therapy for coronary artery bypass surgery in patients with hemophilia A and B . J Card Surg 2018 ; 33 ( 2 ): 76 - 82 . doi: 10.1111/jocs.13530 https://dx.doi.org/10.1111/jocs.13530 . DOI: 10.1111/jocs.13530 http://doi.org/10.1111/jocs.13530

Shalabi A ., Kachel E , Kogan A , et al . Cardiac surgery in patients with hemophilia: is it safe? . J Cardiothorac Surg 2020 ; 15 ( 1 ): 76 . doi: 10.1186/s13019-020-01123-0 https://dx.doi.org/10.1186/s13019-020-01123-0 DOI: 10.1186/s13019-020-01123-0 http://doi.org/10.1186/s13019-020-01123-0

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