拉玛蒂博迪医院对血友病性关节积血的外科矫形治疗

Surgical orthopedic correction of hemophilic hemarthrosis at Ramathibodi Hospital.

作者信息

Isarangkura P, Keorochana S, Chuansumrit A, Jitpraphai C, Mahaphan W, Hathirat P, Chiewsilp P, Prachathumrong P, Pintadit P, Panthangkura W

机构信息

Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Southeast Asian J Trop Med Public Health. 1993;24 Suppl 1:253-5.

PMID:7886589

Abstract

During 1982-1992, 15 major surgical orthopedic correction (SOC) were performed in 12 hemophiliacs. There were 11 synovectomy, 2 osteotomy, 1 currettage and suture wound, 1 release of multiple joint contracture and 1 removal of pseudotumour. During 1982-1989, frozen cryoprecipitate was entirely used for replacement therapy in 5 cases who had 7 SOC. During 1990-1992, 7 cases received SOC by using factor VIII concentrate (Emoclot or Profilate) alone or combined with cryoprecipitate in 8 SOC. Multiple surgical procedures could be performed by using factor VIII concentrates. The orthopedist could operate 3 joints in one setting ie right knee, left knee and right middle finger. There are many advantages of factor VIII concentrates over those of cryoprecipitate, especially in the aspect of HIV transmission by HIV seronegative blood products. The disadvantage is the extremely high cost of factor concentrates.

摘要

1982年至1992年期间，对12名血友病患者进行了15次主要的外科骨科矫正手术（SOC）。其中包括11次滑膜切除术、2次截骨术、1次刮除术及伤口缝合、1次多处关节挛缩松解术和1次假肿瘤切除术。1982年至1989年期间，5例接受7次SOC的患者完全使用冷冻冷沉淀进行替代治疗。1990年至1992年期间，7例患者在8次SOC中单独使用凝血因子VIII浓缩物（Emoclot或Profilate）或与冷沉淀联合使用。使用凝血因子VIII浓缩物可以进行多次外科手术。骨科医生可以在一次手术中对3个关节进行手术，即右膝、左膝和右手中指。与冷沉淀相比，凝血因子VIII浓缩物有许多优点，特别是在HIV血清阴性血液制品传播HIV方面。缺点是凝血因子浓缩物成本极高。