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重度甲型血友病患者的全髋关节置换术:挑战与可行性

Total Hip Replacement in Severe Haemophilia A: Challenges and Feasibility.

作者信息

Bhattacharjee Sujoy K, Naim Farhan

机构信息

Orthopedics, Sarvodaya Hospital and Research Centre, Faridabad, IND.

Hematology, Sarvodaya Cancer Institute, Faridabad, IND.

出版信息

Cureus. 2022 Oct 2;14(10):e29847. doi: 10.7759/cureus.29847. eCollection 2022 Oct.

Abstract

The management of haemophilic patients is complicated due to multiple comorbidities. A dedicated haemophilia treatment centre with a multidisciplinary team can plan and execute elective orthopaedic surgery in such haemophilic individuals. A cementless total hip arthroplasty (THA) was performed in a 26-year-old male patient with haemophilic arthropathy of the right hip under factor VIII replacement therapy based on activated partial thromboplastin time levels. The patient received a preoperative dose of recombinant anti-haemophilic factor. Venous thromboembolic event prophylaxis was not given. Postoperative radiographs demonstrated successful prosthesis placement. The patient could bear weight and walk unassisted two weeks after surgery. THA in patients with haemophilia leads to significant improvement in joint function with a relatively low incidence of complications with modern techniques and haematological management.

摘要

由于多种合并症,血友病患者的管理较为复杂。一个配备多学科团队的专门血友病治疗中心可以为这类血友病患者规划并实施择期骨科手术。一名26岁男性血友病性髋关节病患者,在根据活化部分凝血活酶时间水平进行因子VIII替代治疗的情况下,接受了无水泥型全髋关节置换术(THA)。患者术前接受了一剂重组抗血友病因子。未进行静脉血栓栓塞事件预防。术后X线片显示假体植入成功。患者术后两周即可负重并独立行走。采用现代技术和血液学管理,血友病患者进行全髋关节置换术可显著改善关节功能,并发症发生率相对较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab35/9630049/c97e05e4e7bc/cureus-0014-00000029847-i01.jpg

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