Isarangkura P, Chuansumrit A, Panthangkura W, Hathirat P, Pandhawong S
Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1987 Dec;18(4):552-7.
The home therapy for hemophilia in Thailand was initiated in 1979. The therapeutic material first used was frozen cryoprecipitate or fresh frozen plasma and later fresh dry plasma (FDP). During 1979-1982, ten patients attended regular home therapy. All of them lived in the rural area which were far from the provincial hospitals. The age ranged from 7 to 15 years with a mean age of 10 years. The duration of follow up ranged from 7 months to 7 years with a mean duration of 3 years. The utilized blood products as FDP varied from 3 to 30 bottles per year with a mean of 16 bottles per year or 0.5-2.9 bottles per kilogram body weight per year which increased gradually as the patients grow up. A total of 252 episodes of bleeding was recorded; mostly hemarthrosis 70% and muscular bleeding 19%. There was no any further disability detected in 6 cases (60%). The significant advantages were the reduction in admission rate from 6-8 admission per year to 0-1 admission per year; economic savings; psychological independence of well being and having a normal life. The disadvantage were inadequate dosage of infused material, delayed consultation and transfer which were preventable. Home therapy for hemophilia by using FDP is recommended for any developing country. It is safe, practical, efficient enough to preserve normal joint status and prevent disability.
泰国的血友病家庭治疗始于1979年。最初使用的治疗材料是冷冻冷沉淀或新鲜冷冻血浆，后来是新鲜干血浆（FDP）。1979年至1982年期间，10名患者接受了定期家庭治疗。他们都生活在远离省级医院的农村地区。年龄在7至15岁之间，平均年龄为10岁。随访时间从7个月到7年不等，平均为3年。每年使用的FDP血液制品从3瓶到30瓶不等，平均每年16瓶，即每年每公斤体重0.5至2.9瓶，随着患者长大而逐渐增加。共记录了252次出血事件；大部分是关节积血（70%）和肌肉出血（19%）。6例（60%）未发现进一步残疾。显著优点是住院率从每年6至8次降至每年0至1次；节省费用；心理上独立，感觉良好并能过上正常生活。缺点是输注材料剂量不足、咨询和转诊延迟，这些都是可以预防的。对于任何发展中国家，推荐使用FDP进行血友病家庭治疗。它安全、实用、足够有效，能够保持关节正常状态并预防残疾。
