予期せぬ大量出血の凝固能評価に血液粘弾性分析装置Quantra®を使用した子宮頸がん合併妊娠の麻酔経験

Anesthetic Experience in a Pregnancy Complicated by Cervical Cancer, with a Quantra® Blood Viscoelasticity Analyzer to Evaluate Coagulability of Unexpected Massive Bleeding

要旨

　血液粘弾性分析装置は，心臓手術の凝固能評価で使用されているが，非心臓手術での大量出血時の凝固能評価に対する有用性も注目されている。今回，子宮頸がん合併妊娠に対し選択的帝王切開術と広汎子宮全摘術を施行した症例の予期せぬ大量出血に対し，血液粘弾性分析装置Quantra^®を用いた症例を紹介する。

　Viscoelastic testing is widely used to evaluate coagulability in cardiac and non-cardiac surgeries. A viscoelastic test device is thought to be effective for assessing coagulability during massive bleeding. We describe the case of a patient who was undergoing an elective Cesarean section and an extensive total hysterectomy for a pregnancy complicated by cervical cancer. Unexpected massive bleeding occurred, and the coagulability was evaluated with a new cartridge-based viscoelastic testing device, the Qantra^® QPlus^® system. As shown in this patient’s case, the Quantra QPlus may be useful for the evaluation of unexpected massive bleeding in non-cardiac surgery.