| 王丽萍,王峥,张琪琪,等.不孕合并凝血因子 Ⅺ、Ⅻ缺乏症病人行体外受精 -胚胎移植后妊娠 2例及文献复习[J].安徽医药,2024,28(5):977-980. |
| 不孕合并凝血因子 Ⅺ、Ⅻ缺乏症病人行体外受精 -胚胎移植后妊娠 2例及文献复习 |
| Two cases of pregnancy after IVF-ET in patients with infertility and factors Ⅺ and Ⅻ deficiency and literature review |
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| DOI：10.3969/j.issn.1009-6469.2024.05.027 |
| 中文关键词: 遗传性联合凝血因子缺乏症 因子 Ⅺ缺乏 经阴道取卵 因子 Ⅻ缺乏 病例报告 文献复习 |
| 英文关键词: Hereditary combined coagulation factor deficiency Factor Ⅺ deficiency Transvaginal oocyte retrieval Ⅻ deficiency Case reports Literature review |
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| 中文摘要: |
| 目的分析行体外受精 -胚胎移植( IVF-ET)的不孕病人合并凝血因子 Ⅺ、Ⅻ缺乏症的临床表现、实验室检查及治疗。方法通过分析 2020―2021年潍坊医学院附属医院生殖医学中心收治的 2例不孕合并凝血因子 Ⅺ、Ⅻ缺乏症病人的临床资料，结合文献复习进行回顾性分析。结果 2例病人均无出血史及血液系统疾病史，既往无月经过多；实验室检查结果均为活化部分凝血酶原时间( APTT)延长，血浆凝血酶原时间( PT)正常，凝血酶时间( TT)正常，凝血因子 Ⅺ、Ⅻ减少； 1例病人在严密监测下未出现取卵术中、术后出血， 1例病人预防性输注新鲜冷冻血浆( FFP)后未出现术中、术后出血； 2例病人分娩前均未预防性输注 FFP，分娩过程顺利，未发生产后出血。结论凝血因子 Ⅺ、Ⅻ缺乏症病人自发性出血少见，无出血症状或出血轻微； APTT、PT、TT是该疾病的常规检查，凝血因子 Ⅺ、Ⅻ活性与出血量无相关性，血栓动力学( TD)可对该疾病进行出血预测，目前缺乏大量前瞻性研究；术前充分评估可有效降低出血风险。 |
| 英文摘要: |
| Objective To analyze the clinical manifestations, laboratory examination and treatment of infertility patients undergoing in vitro fertilization-embryo transfer (IVF-ET) with coagulation factors Ⅺ and Ⅻ deficiency.Methods By analyzing the clinical dataof 2 patients with infertility combined with factors Ⅺ and Ⅻ deficiency who were admitted to Center for Reproductive Medicine of TheAffiliated Hospital of Weifang Medical University from 2020 to 2021, a retrospective analysis was carried out in combination with litera-ture review.Results Both patients had no history of bleeding and hematologic diseases, and had no previous menorrhagia. Laboratorytest results showed that the activated partial thromboplastin time (APTT) was prolonged, the prothrombin time (PT) and the thrombintime (TT) were normal, and the coagulation factors Ⅺ and Ⅻ were reduced. One patient did not have intraoperative or postoperativebleeding from transvaginal oocyte retrieval under close monitoring, and the other patient had no intraoperative or postoperative bleedingafter preventive transfusion of fresh frozen plasma (FFP). Neither patient received prophylactic FFP before delivery, and the deliveryprocess was smooth without postpartum bleeding.Conclusions Spontaneous hemorrhage is rare in patients with factors Ⅺ and Ⅻ defi-ciency, with no bleeding symptoms or mild bleeding. APTT, PT, TT are routine examinations of the disease, coagulation factors Ⅺ, Ⅻactivity has no correlation with bleeding volume, and thrombodynamics (TD) can predict bleeding of the disease, but there is currentlyinsufficient number of prospective studies. Adequate evaluation of patient′s condition before surgery can effectively reduce the risk ofbleeding. |
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