先天性第VII因子欠損症の巨大卵巣嚢腫切除術における止血管理

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  • Hemostatic Management with Prothrombin Complex Concentrate in a Patient with Factor VII Deficiency Undergoing Resection of a Large Ovarian Cyst

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説明

A 24-year-old Japanese woman with congenital factor VII deficiency (factor VII less than 0.01U/ml) developed a large cyst in the right ovary. She had a history of recurrent joint bleeding and menorrhagia that had been treated with prothrombin complex concentrate (PCC, Proplex® ST). She underwent right adnectomy successfully with repeated replacement therapy using Proplex® ST (1, 755 U of FVII: C per vial). Pharmacokinetics study of Proplex® ST revealed that the biological half-life and in vivo recovery of FVII: C were 5.6h and 152%, respectively. Two vials of Proplex® ST were given prior to surgery and every 8 hours until 48 hours after surgery, yielding a peak plasma FVII: C level of approximately 1.62U/ml and a trough level of 0.16U/ml. Subsequently, one vial was given every 8 hrs until 16 hours after surgery, resulting in a peak level of 1.07U/ml and a trough level of 0.08U/ml. The administration interval of PCC was prolonged thereafter and the replacement therapy was terminated on the 6th postoperative day. No abnormal bleeding or thrombotic events occurred during the perioperative course.

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