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血管栓塞联合截肢治疗复发性血友病性假肿瘤。

Vascular embolization combined with amputation for recurrent hemophilic pseudotumor.

作者信息

Lv Shuaijie, Chen Lei, Tang Yi, Gong Yichen, Tong Peijian, Guo Jiayi, Zhang Zhongyi

机构信息

The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Shangcheng District, Hangzhou City, Zhejiang Province, China.

Luoyang Orthopedic-Traumatological Hospital of Hehan Province (Henan Provincial Orthopedic Hospital), No. 82, Qiming South Road, Chanhe Hui District, Henan, Luoyang, China.

出版信息

BMC Musculoskelet Disord. 2025 Aug 11;26(1):775. doi: 10.1186/s12891-025-09031-x.

Abstract

Hemophilic pseudotumor is a rare, life - threatening complication of hemophilia. Surgical treatment presents substantial challenges, particularly in coagulation management, perioperative wound healing, and infection control. We present a case of recurrent pseudotumor with refractory wound healing following multiple surgical interventions, which was successfully managed through a multidisciplinary approach combining vascular embolization with amputation. The case involves a 28-year-old male patient with hemophilia-associated pseudotumor who presented with a two-year history of impaired wound healing following right above-knee amputation. Clinical examination revealed significant swelling and tenderness in the right thigh region, accompanied by persistent drainage of black viscous exudate from the surgical site. Due to pseudotumor recurrence and chronic wound complications, a multidisciplinary team comprising hematology, interventional radiology, and orthopedic specialists implemented a combined therapeutic strategy of preoperative vascular embolization followed by definitive amputation. The postoperative course demonstrated favorable outcomes, with complete wound healing and no evidence of disease recurrence during the 6-month follow-up observation period.

摘要

血友病性假肿瘤是血友病一种罕见的、危及生命的并发症。手术治疗面临重大挑战,尤其是在凝血管理、围手术期伤口愈合和感染控制方面。我们报告一例在多次手术干预后出现复发性假肿瘤且伤口愈合困难的病例,通过血管栓塞与截肢相结合的多学科方法成功进行了处理。该病例涉及一名28岁男性血友病相关假肿瘤患者,其右膝上截肢后伤口愈合不良已有两年病史。临床检查发现右大腿区域明显肿胀和压痛,手术部位持续有黑色粘性渗出物引流。由于假肿瘤复发和慢性伤口并发症,由血液学、介入放射学和骨科专家组成的多学科团队实施了术前血管栓塞然后进行确定性截肢的联合治疗策略。术后过程显示出良好的结果,伤口完全愈合,在6个月的随访观察期内无疾病复发迹象。

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