Hutchinson R J, Penner J A, Hensinger R N
Pediatrics. 1983 Apr;71(4):631-3.
Surgical synovectomy employed in the management of hemophilic arthropathy has been contraindicated in patients with inhibitors because of potential difficulties in achieving hemostasis. However, the development of activated prothrombin-complex concentrates has improved the management of hemophiliacs with inhibitors, particularly those with high levels of inhibitor for whom other treatment modalities are of minimal benefit. With the use of one of these activated products, Autoplex, surgical procedures have been successfully accomplished in hemophiliacs with inhibitors. Two inhibitor patients who each had severe arthropathy of one knee underwent elective surgical synovectomy while being treated with Autoplex. Hemostasis was achieved during the perioperative period in both patients. Neither patient exhibited clinical signs of suggestive of consumptive coagulopathy or thrombosis, side effects potentially associated with the use of activated prothrombin-complex concentrates.
由于在血友病性关节病的治疗中，手术滑膜切除术在有凝血因子抑制物的患者中可能难以实现止血，因此一直被视为禁忌。然而，活化凝血酶原复合物浓缩剂的出现改善了对有抑制物的血友病患者的治疗，特别是那些抑制物水平高且其他治疗方式效果甚微的患者。使用其中一种活化产品Autoplex后，有抑制物的血友病患者成功完成了外科手术。两名各有一侧膝关节严重关节病的抑制物患者在接受Autoplex治疗期间接受了择期手术滑膜切除术。两名患者围手术期均实现了止血。两名患者均未出现提示消耗性凝血病或血栓形成的临床症状，这些是与使用活化凝血酶原复合物浓缩剂潜在相关的副作用。
