Rodriguez-Merchan E C
La Paz University Hospital, Madrid, Spain.
Haemophilia. 2001 Jan;7(1):1-5. doi: 10.1046/j.1365-2516.2001.00481.x.
The aim of both synoviorthesis and surgical synovectomy is to remove the inflamed and hypervascular synovium as soon as possible in order to prevent the onset of haemophilic arthropathy. Ideally, however, these methods should be performed before the articular cartilage has eroded. Radioactive synoviorthesis is a relatively simple, virtually painless and inexpensive technique for the treatment of chronic haemophilic synovitis, even in patients with inhibitors. Thus, radioactive synoviorthesis is the best choice for patients with persistent synovitis. Personal experience and the general recommendation among orthopaedic surgeons and haematologists is that when three early consecutive synoviorthesis (repeated every 3 months) fail to halt synovitis, a surgical synovectomy (open or by arthroscopy) should be immediately considered.
滑膜切除术和外科滑膜切除的目的都是尽快切除发炎和血管增生的滑膜，以预防血友病性关节病的发生。然而，理想情况下，这些方法应在关节软骨侵蚀之前进行。放射性滑膜切除术是一种相对简单、几乎无痛且成本低廉的治疗慢性血友病性滑膜炎的技术，即使对于有抑制剂的患者也是如此。因此，放射性滑膜切除术是持续性滑膜炎患者的最佳选择。个人经验以及骨科医生和血液科医生的普遍建议是，当连续三次早期滑膜切除术（每3个月重复一次）未能阻止滑膜炎时，应立即考虑进行外科滑膜切除术（开放手术或关节镜手术）。
