Department of Medicine and Surgery, University of Parma, Parma, Italy.
Department of Physical and Rehabilitation Medicine, University Hospital of Padua, Padua, Italy.
Acta Biomed. 2021 Apr 30;92(S1):e2021118. doi: 10.23750/abm.v92iS1.10983.
Haemophilia A is a rare inherited hematologic disorder characterized by a deficit of coagulation factor VIII. It is associated with frequent episodes of musculoskeletal bleedings that occur mainly inside joints and secondly inside muscles. The majority of intramuscular hematomas respond well to conservative protocols, based on rehabilitation techniques and appropriate haemostatic coverage; surgery is limited to refractory cases. This manuscript describes the management of an intramuscular bleeding in a young patient with severe haemophilia A and high-titre inhibitors. A multidisciplinary approach directed by a physiatrist and combining surgical intervention, use of bypassing agents and rehabilitation treatment allowed to successfully managing this case, leading to a complete functional recovery. Given the lack of consensus on the treatment of intramuscular bleedings in haemophiliac patients, this case report provides an example of successful management for such conditions, which require a multidisciplinary approach in which the physiatrist plays a key role.
甲型血友病是一种罕见的遗传性血液疾病，其特征是凝血因子 VIII 缺乏。它与频繁的肌肉骨骼出血有关，这些出血主要发生在关节内，其次发生在肌肉内。大多数肌肉内血肿对基于康复技术和适当止血覆盖的保守方案反应良好；手术仅限于难治性病例。本文描述了一名患有严重甲型血友病和高滴度抑制剂的年轻患者的肌肉内出血的管理。由物理治疗师指导的多学科方法，结合手术干预、旁路药物的使用和康复治疗，成功地管理了这种情况，导致完全的功能恢复。鉴于在血友病患者的肌肉内出血治疗方面缺乏共识，本病例报告提供了此类疾病成功管理的范例，此类疾病需要多学科方法，其中物理治疗师发挥关键作用。
