保存血大量輸血に伴う出血傾向に対する線維素溶解現象の発現とその対策 第1編 保存血大量輸血時の線維素溶解現象発現機序に対する検討

The mechanism of fibrinolysis following massive transfusion of preserved blood was investigated, clinically and experimentally. Results obtained were as follows: 1. Fibrinolytic activity was not seen in the preserved blood, and the fibrinolysis observed in the transfusion of preserved blood was derived from preserved blood itself which acted upon as a stress, but it was slight in the degree. On the other hand, the fibrinolysis was relatively remarkable in the cases undertaking sugical procedures, especially a pulmonary operation, and etc. However, it was not considered that either one of above cases would become to develop a hemorrhagic tendency. 2. Fibrinogen level did not show a remarkable change with a massive transfusion of preserved blood, but was decreased in the cases operated upon the organs being high in the thromboplastin level and became a cause of a hemorrhagic tendency. 3. A hemorrhagic tendency was not always observed even in the cases showing highly positive fibrinolysis, but it was thought to be cased by the defects in platelet, vascular and coagulation factors of many kinds, in conjuction with the changes in general and local conditions of patients, and with surgical procedures. The fibrinolysin, however, promoted the development of hemorrhagic tendency following the disturbances in vascular and various kinds of coagulation factors.