Repair of thoracoabdominal aortic aneurysms (TAAA) is associated with major blood loss, often exceeding the patient's intravascular volume, and complex intraoperative and postoperative coagulopathies necessitating large-volume transfusion of blood products. Abnormalities sufficient to cause thrombocytopenia or clinically important prolongation of clotting parameters are rarely present before surgery in elective aneurysms but are more common with ruptured aneurysms. The finding of intraoperative and postoperative deficiencies of clotting factors, along with thrombin generation and activation of the thrombolytic system, is reflective of massive blood losses, visceral ischemia, and massive transfusions. An aggressive strategy of transfusion of blood products is critical to the prevention of clinically significant coagulopathy during surgery. Adjuncts to reduce blood losses and blood product use include low-dose aprotinin or epsilon -aminocaproic acid, intraoperative blood salvaging, and acute normovolemic hemodilution. In TAAA repair, an average blood loss of 5000 to 6000 mL and average transfusion of allogeneic blood products of 50 to 60 U are to be anticipated.

中文翻译：

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胸腹主动脉瘤修复患者的凝血功能障碍和血液制品使用情况。

胸腹主动脉瘤（TAAA）的修复与大量失血有关，常常超过患者的血管内容量，并且复杂的术中和术后凝血病需要大量输血。选择性动脉瘤在手术前很少会出现足以引起血小板减少或临床上重要的凝血参数延长的异常现象，但在破裂性动脉瘤中更为常见。术中和术后凝血因子缺陷的发现，以及凝血酶的产生和溶栓系统的激活，反映了大量失血，内脏局部缺血和大量输血。积极输血产品对预防手术期间临床上明显的凝血病至关重要。减少失血量和使用血液制品的辅助措施包括低剂量抑肽酶或ε-氨基己酸，术中血液挽救和急性降血常规血液稀释。在TAAA修复中，预计平均失血量为5000至6000 mL，异体血液制品的平均输血量为50至60U。