書誌事項
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- A suspicious case of massive hemorrhaging from an epidural puncture aperture resulting from coagulopathy caused by vitamin K deficiency associated with fasting and antibiotics
- ショウレイ ゼッショク ・ コウセイブツシツ トウヨ ニ ヨル ビタミン K ケツボウ ニ キイン スル ト オモワレル ギョウコ ショウガイ デ コウマク ガイ センシブ ヨリ タリョウ ノ シュッケツ オ ミトメタ 1レイ
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説明
We experienced a surgical case with a large amount of hemorrhaging from an epidural puncture aperture immediately after surgery. The clotting studies, which were screened five days prior to surgery, were within normal limits. In the postoperative clotting studies, prothrombin time (PT) and hepaplastin test (HPT) demonstrated an unexpected coagulopathy, but activated partial thromplastin time (APTT) was still normal. These findings suggest that F VII, which is a vitamin K-dependent coagulation factor, should be decreased. So we suspected that this coagulopathy was caused by vitamin K deficiency. Preoperative oral limitation, insufficient absorption caused by ileus and treatment with cephem antibiotics had led to this deficiency. Vitamin K and fresh frozen plasma were intravenously administered just after these findings, and bleeding tendency was then improved; this patient now has no neurological impairment. We should pay attention when we administer cephem antibiotics containing N-methyl-thiotetrazole to a patient with long time fasting.
収録刊行物
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- 日本ペインクリニック学会誌
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日本ペインクリニック学会誌 19 (4), 519-522, 2012
一般社団法人 日本ペインクリニック学会
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詳細情報 詳細情報について
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- CRID
- 1390282679434730496
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- NII論文ID
- 10031127009
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- NII書誌ID
- AN10440947
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- ISSN
- 18841791
- 13404903
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- NDL書誌ID
- 024163381
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- 本文言語コード
- ja
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- JaLC
- NDLサーチ
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