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Hypofibrinogenemia Caused by Hemocoagulase After Colon Polyps Excision

机译:结肠息肉切除术后的血凝酶引起的低纤维蛋白原血症

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Objective: Unusual or unexpected effect of treatmentBackground: In patients with large colon polyps, late-onset bleeding may be more likely to occur because of the larger cutting surface. In these patients, hemostatic agents may be applied to prevent the late-onset bleeding. A total of 7 patients developed hypofibrinogenemia caused by hemocoagulase following excision of colon polyps in our center from November to December 2015.Case Report: Seven patients underwent excision of colon polyps in our center from November to December 2015. The cutting face was large in these patients after surgery; therefore, hemocoagulase was used to prevent potential late-onset bleeding. Evaluation of clotting function showed that the fibrinogen level was normal before surgery in all 7 patients. Hemocoagulase was intravenously administered twice daily beginning from postoperative day 1. Hypofibrinogenemia of varying severity occurred 2–4 d later. Three patients also had lower-gastroin-testinal bleeding. After drug withdrawal and infusion of fibrinogen, blood fibrinogen level gradually returned to normal. In contrast, among 13 patients who had not received hemocoagulase treatment for preventing hemorrhage following excision of colon polyps, detection of blood fibrinogen before surgery and 2–4 d after showednormal results.Conclusions: Routine use of Hemocoagulase For Injection for the prevention of late-onset bleeding is not recommended for patients who have undergone excision of colon polyps. Hemocoagulase following excision of colon polyps can cause hypofibrinogenemia and even lower-gastrointestinal bleeding.
机译:目的:治疗效果异常或出乎意料背景:在结肠息肉较大的患者中,由于切割面较大,可能更容易发生迟发性出血。在这些患者中,可以使用止血剂来预防迟发性出血。 2015年11月至2015年12月,我们中心切除了结肠息肉后,共有7例因凝血酶引起的血纤维蛋白原缺乏症。病例报告:2015年11月至2015年12月,我中心切除了结肠息肉,共有7例患者。手术后的病人因此,使用血凝酶预防潜在的迟发性出血。凝血功能的评估表明,所有7例患者术前血纤维蛋白原水平均正常。从术后第1天开始,每天两次静脉给予血凝酶。术后2–4 d发生不同程度的低纤维蛋白原血症。三名患者也有下消化道-肠道出血。停药并输注纤维蛋白原后,血液中纤维蛋白原水平逐渐恢复正常。相比之下,在13例因结肠息肉切除而未接受预防出血的凝血酶治疗的患者中,术前和术后2-4 d检测血纤维蛋白原均显示正常结果。结论:常规使用注射血凝酶预防晚期肝炎的方法。不建议已切除结肠息肉的患者发生大出血。切除结肠息肉后的血凝酶可导致血纤维蛋白原减少,甚至引起下消化道出血。

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