Anesthesiology and Reanimation Department, Ondokuz Mayis University Faculty of Medicine, Pain Clinic, Samsun, Turkey.
Department of Internal Medicine, Ondokuz Mayis University Faculty of Medicine, Haematology Clinic, Samsun, Turkey.
Ann Hematol. 2023 Apr;102(4):947-953. doi: 10.1007/s00277-023-05134-4. Epub 2023 Feb 23.
Repetitive bleeding attacks may cause joint pain and arthropathy in patients with hemophilia (PWH). Despite being a common symptom, pain is not a well-studied topic in this disease. The aim of this cross-sectional, observational study was to assess the frequency and intensity of pain and analyze the success rates ofpain treatment methods. Adult hemophilia patients were included in the study. The Multidimensional Hemophilia Pain Questionnaire (MHPQ) was used to assess pain. In addition to the MHPQ, demographic data were collected. Fifty adult hemophilia patients were included in the study. Thirty-one (62%) of the patients reported pain due to hemophilia in the last year. Twenty-six of them (81.2%) reported pain during bleeding attacks. The most successful pain coping strategy was clotting factor replacement. None of the participants used opioids or adjuvant analgesics. None of them used a physical therapy modality or interventional pain therapy method. While 67.6% of the patients were very dissatisfied or dissatisfied with their global pain treatment, only 16.1% of the patients were satisfied or very satisfied. Patients with higher pain during bleeding episodes were more likely to continue their prophylaxis. There was no significant difference between plasma-derived or recombinant-derived factor prophylaxis in terms of pain complaints. Pain is a frequent and important symptom of hemophilia, but most of the patients are not treated sufficiently. A multidisciplinary approach is needed to improve the life quality of the patients. In addition to successful bleeding prophylaxis, administration of a proper and adequate analgesic regimen and combined physical therapy modalities may decrease pain intensity and prevent the development of arthropathy.
重复性出血发作可能导致血友病患者(PWH)出现关节疼痛和关节病。尽管疼痛是该病的常见症状,但并未得到充分研究。本横断面观察性研究旨在评估疼痛的频率和强度,并分析疼痛治疗方法的成功率。研究纳入成年血友病患者。采用多维血友病疼痛问卷(MHPQ)评估疼痛。除 MHPQ 外,还收集了人口统计学数据。本研究纳入了 50 名成年血友病患者。31 名(62%)患者在过去一年中因血友病出现疼痛。其中 26 名(81.2%)在出血发作期间出现疼痛。最成功的疼痛应对策略是凝血因子替代治疗。没有参与者使用阿片类药物或辅助镇痛剂。没有参与者使用物理治疗模式或介入性疼痛治疗方法。尽管 67.6%的患者对整体疼痛治疗非常不满意或不满意,但只有 16.1%的患者满意或非常满意。在出血发作期间疼痛更严重的患者更有可能继续进行预防治疗。在血浆衍生或重组衍生因子预防治疗方面,疼痛投诉没有显著差异。疼痛是血友病的一个常见且重要的症状,但大多数患者的治疗并不充分。需要采取多学科方法来提高患者的生活质量。除了成功预防出血外,还应给予适当和充分的镇痛方案以及联合物理治疗模式,以减轻疼痛强度并预防关节病的发展。