White G C, Blatt P M, McMillan C W, Webster W P, Lesesne H R, Roberts H R
South Med J. 1980 Feb;73(2):155-60. doi: 10.1097/00007611-198002000-00011.
The modern, comprehensive care of patients with hemophilia requires an awareness that complications other than those caused by acute hemorrhage can occur. The use of newer, more potent plasma concentrates has been accompanied by an increased incidence of liver disease in transfusion-requiring hemophiliacs. The progression to chronic active hepatitis and cirrhosis are particularly ominous developments in these patients. There is also a high incidence of urinary tract abnormalities in hemophiliacs, though the long-term consequences of these abnormalities are unknown. Furthermore, it must be remembered that urinary tract disorders unrelated to hemorrhage, such as nephrolithiasis, tumors, and nephritis, can occur in patients with hemophilia and may be mistaken for hemorrhage. Finally, hypertension occurs more frequently in patients with hemophilia than in the general population and may in part contribute to the occurrence of bleeding within the central nervous system. Methods for evaluating and treating these various disorders are discussed. Greater awareness of these potentially treatable medical complications will improve further the quality of care in hemophilia.
现代血友病患者的综合护理需要认识到，除急性出血引起的并发症外，其他并发症也可能发生。使用更新、更强效的血浆浓缩物伴随着需要输血的血友病患者肝病发病率的增加。进展为慢性活动性肝炎和肝硬化在这些患者中是特别不祥的发展。血友病患者泌尿系统异常的发生率也很高，尽管这些异常的长期后果尚不清楚。此外，必须记住，与出血无关的泌尿系统疾病，如肾结石、肿瘤和肾炎，可发生在血友病患者中，可能被误诊为出血。最后，血友病患者高血压的发生率高于一般人群，可能部分导致中枢神经系统出血的发生。本文讨论了评估和治疗这些各种疾病的方法。对这些潜在可治疗的医学并发症有更高的认识将进一步提高血友病的护理质量。
