Chuansumrit Ampaiwan, Mahasandana Chularatana, Chinthammitr Yingyong, Pongtanakul Boonchu, Laossombat Vichai, Nawarawong Weerasak, Lektakul Yuchinda, Wangruangsatid Somporn, Sriboriboonsin Ladda, Rojnakarin Ponlapat, Angchaisuksiri Pantep
Faculty of Medicine at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2004 Jun;35(2):445-9.
A national survey of patients with hemophilia and other congenital bleeding disorders in Thailand was conducted in the years 2000 to 2002. Questionnaires were sent to physicians working at hospitals throughout the country. Although the overall response rate to the questionnaires was 19%, the two highest rates of 80% and 73.7% were found at university and regional hospitals, respectively, where most of the patients received their diagnosis and treatment. A total of 1,450 patients comprised of hemophilia 1,325 cases, von Willebrand disease, 69 cases, congenital factor VII deficiency, 15 cases, hereditary platelet dysfunction, 22 cases, and undefined causes of congenital bleeding disorders, 19 cases. Most were pediatric patients <15 years of age. Treatment was mainly given on demand for a bleeding episode, while only 8.6% received additional home treatment for early bleeding episodes. Replacement therapy primarily relied on fresh frozen plasma, cryoprecipitate and cryo-removed plasma. Factor concentrate was seldom used because of the high price. As a result, hemophilia care services in Thailand should be strengthened by providing comprehensive education for medical personnel, making available simple laboratory kits to determine hemophilia A and B, ensuring an adequate supply of blood components and affordable factor concentrate, and establishing home care treatment.
2000年至2002年期间,泰国针对血友病及其他先天性出血性疾病患者开展了一项全国性调查。调查问卷被发送给全国各地医院的医生。尽管问卷的总体回复率为19%,但在大学医院和地区医院分别发现了最高的回复率,即80%和73.7%,大多数患者在这些医院接受诊断和治疗。共有1450名患者,其中血友病1325例、血管性血友病69例、先天性因子VII缺乏症15例、遗传性血小板功能障碍22例,以及先天性出血性疾病病因不明者19例。大多数是15岁以下的儿科患者。治疗主要是在出血发作时按需进行,而只有8.6%的患者在早期出血发作时接受了额外的家庭治疗。替代疗法主要依赖新鲜冰冻血浆、冷沉淀和去冷沉淀血浆。由于价格高昂,很少使用凝血因子浓缩剂。因此,泰国应通过为医务人员提供全面教育、提供用于诊断甲型和乙型血友病的简易实验室试剂盒、确保血液成分的充足供应和价格合理的凝血因子浓缩剂,以及建立家庭护理治疗等方式,加强血友病护理服务。