血友病性骨关节病围手术期干预策略的探讨  

A retrospective analysis of intervention management of hemophilic arthropathy during perioperative period

作　　者：郝运[1] 何金鹏[1] 郭风劲[1] HAO Yun HE Jin-peng Guo Feng-jing.(Tongji Hospital, Tongfi Medical College, Huazhong University of Science and Technology, Wuhan 430030, Chin)

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2016年第5期340-343,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨血友病性骨关节病患者在围手术期的临床特征和治疗干预策略。方法:回顾行手术治疗的10例血友病性骨关节病患者的相关临床资料,对其临床特征、影像学表现、治疗和转归等资料进行分析。结果:10例患者共行手术治疗13次,其中行关节置换5例;行血肿假性肿瘤切除术5例,其中1例同时行关节置换术;行关节镜下滑膜清理4例,其中1例同时行另一部位关节置换术;行关节融合2例;跟腱延长+筋膜松解术1例。围手术期均行Ⅷ因子补充替代治疗,全部13例患者伤口愈合良好,1例患者未拆线出院,其余患者均拆线后出院。结论:经过系统性Ⅷ因子补充替代治疗后血友病A患者也能够获得较为理想的手术治疗效果,术后并发症可以得到有效控制。Objective ： To investigate the clinical characteristics and the treatment strategy of hemophilic arthropathy dur- ing the perioperative period. Methods ： Ten patients with hemophilic arthropathy received operations and their clinical charac- teristics, radiography features and treatment strategies were explored retrospectively. Results： Ten patients received 13 times of operation, including 5 patients were given joint replacement operations, 5 patients given tumor resection operations of he- matoma （including one undergoing joint replacement operation at the same time）, 4 patients given synovectomy and joint de- bridement under arthroscopy （including a patient undergoing joint fusion at the same time）, 2 patients given joint fusion op- erations, and 1 patient given synchronous Achilles tendon lengthening with fascia release. All patients received systemic treatment for Ⅷ factor supplements. All wounds healed well and the sutures were removed except one patient. Conclusion： After systemic treatment with Ⅷ factor supplements, the complications can be controlled well and those patients with hemo- philic arthropathy can receive a safe operation and obtain a good prognosis.

关 键 词：血友病 并发症 围手术期 血友病骨关节炎 血友病假性肿瘤 

分 类 号：R554.1[医药卫生—血液循环系统疾病]