亚临床型血友病A合并颅脑外伤的围手术期处理2例分析

为了探讨亚临床型血友病A患者合并颅脑外伤行手术治疗时的围手术期处理方法，2例亚临床型血友病A合并颅脑外伤患者术后确诊，在围手术期通过动态的监测血Ⅷ因子活性（FⅧ：C）水平，调整FⅧ输入并维持FⅧ：C在止血水平（30％～50％），至伤口愈合。结果显示，2例亚临床型血友病A合并颅脑外伤手术患者，术后都得到了及时的恢复。提示亚临床型血友病A合并颅脑外伤患者关键是准确诊断，围手术期要求保持血中凝血因子FⅧ的促凝活性维持在止血水平，直到伤口愈合为止。

Perioperative Management of Two Cases of Subclinical Hemophiliac A with Head Trauma

This article is to discuss the perioperative management of subclinical hemophiliac A （SHA） with head trauma in two patients. After final diagnosis of SHA, to regulate the injection of factor Ⅷ concentrate in perioperation by dynamic testing the level of factor Ⅷ in 2 cases. The haemostatic lever of factor Ⅷ ： C was maintained at 30%-50% postoperatively to reach intention. Two patients perioperatively were cured timely by regulating the injection of factor Ⅷ. Therefore, accurate diagnosis is the key to SHA with head trauma. It is necessary to promise the factor Ⅷ ： C being maintained at the lever of hemostasis during the perioperation to reach intention.