A 75-year-old man sustained a subdural hematoma, grade II splenic injury, and pelvic fracture in a motor vehicle collision. His Glasgow Coma Scale (GCS) score is 8, and he is intubated in the emergency department. His past medical history includes hypertension, diabetes, atrial fibrillation, and chronic renal insufficiency. Vital signs are: blood pressure 110/86 mm Hg, heart rate 105 beats/min. His wife says that he took apixaban four hours before the accident. His hemoglobin is 8.9 g/dL, and serum creatinine is 1.5 mg/dL. He is admitted to ICU for resuscitation. He will undergo emergency craniotomy after the coagulopathy is corrected.
Which of the following is the best way to treat this patient’s coagulopathy?
A. Prothrombin complex concentrate
B. Freshfrozen plasma
C. Recombinant factor VIIa
D. Tranexamic acid
E. Emergency hemodialysis
答案解析：
目前对直接 Xa 因子抑制剂的管理建议是在摄入后 4 小时内使用活性炭和四因子凝血酶原复合物浓缩物 (PCC) 或活性 PCC (FEIBA)。
正确答案：A
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