Aronstam A, Wassef M, Hamad Z, Aston D L
Clin Lab Haematol. 1982;4(1):17-21. doi: 10.1111/j.1365-2257.1982.tb00054.x.
One hundred and thirty-seven knee bleeds treated with an initial dose of 11-16 units of factor VIII/kg have been reviewed in an attempt to find the predictive factors for bleeds requiring retransfusion. Thirty-two bleeds (23.4%) were retransfused within 48 hours because of extension of bleeding or poor progress. Fifty-nine per cent of bleeds which were retransfused presented with pain and 72% were tender at presentation. These figures contrasted with those for bleeds which were not retransfused of 30% and 45%. The difference in each case is significant. Forty-seven per cent of retransfused bleeds presented with less than 50% of normal movement against 12% who were not retransfused. This difference was also highly significant. It is suggested that knee bleeds presenting with pain, tenderness and/or more than 50% restriction of movement should be considered for higher initial doses of factor VIII.
对137例首次剂量为每千克体重11 - 16单位凝血因子VIII治疗的膝关节出血病例进行了回顾，以寻找需要再次输血的出血预测因素。32例出血（23.4%）在48小时内因出血扩展或进展不佳而接受了再次输血。接受再次输血的出血病例中，59%在就诊时伴有疼痛，72%有压痛。这些数字与未接受再次输血的出血病例的30%和45%形成对比。每种情况的差异均具有显著性。接受再次输血的出血病例中有47%的膝关节活动度低于正常的50%，而未接受再次输血的病例中这一比例为12%。这种差异也非常显著。建议对于伴有疼痛、压痛和/或活动度受限超过50%的膝关节出血，应考虑给予更高的初始剂量凝血因子VIII。
