钇-90 硅酸盐放射性滑膜切除术治疗血友病性关节病的长期随访
Long term follow up of radiosynovectomy with yttrium-90 silicate in haemophilic haemarthrosis.
作者信息
van Kasteren M E, Nováková I R, Boerbooms A M, Lemmens J A
机构信息
Department of Haematology, University Hospital Nijmegen, The Netherlands.
出版信息
Ann Rheum Dis. 1993 Jul;52(7):548-50. doi: 10.1136/ard.52.7.548.
OBJECTIVES
The aim of this study was to evaluate the long term effect of radiation synovectomy with yttrium-90 silicate in haemophiliac patients with recurrent haemarthrosis.
METHODS
The bleeding frequency and the mobility of the joint were recorded in 16 joints of 14 patients 1 year before radiosynovectomy and during follow up, which ranged from 3 to 6 years. Patients evaluated the effect of their own treatment by completing a questionnaire. Radiographs of the joints were scored by an independent radiologist before treatment.
RESULTS
A satisfactory reduction of the frequency of haemorrhage was achieved in 94% of joints during the first year after treatment and was maintained in 63% until the end of the follow up period. In general there was no decrease in mobility attributable to radiosynovectomy, and the patients' own evaluations agreed with the evaluations based on the frequencies of haemarthrosis in 75%. Patients who had only minor, or no, radiological abnormalities of the joints before treatment showed the best results. One patient developed synovitis as a complication of the radiosynovectomy.
CONCLUSION
Radiosynovectomy is an effective and safe treatment for recurrent haemarthrosis in haemophiliac patients, especially in those who have joints with no or minor radiological damage.
目的
本研究旨在评估用90钇硅酸盐进行放射性滑膜切除对血友病性复发性关节积血患者的长期疗效。
方法
记录了14例患者16个关节在放射性滑膜切除术前1年及随访期间（3至6年）的出血频率和关节活动度。患者通过填写问卷评估自身治疗效果。治疗前由一名独立放射科医生对关节X光片进行评分。
结果
治疗后第一年，94%的关节出血频率得到了令人满意的降低，直至随访期结束，63%的关节仍保持这一效果。总体而言，放射性滑膜切除并未导致关节活动度下降，患者自身评估与基于关节积血频率的评估结果在75%的情况下相符。治疗前关节仅有轻微或无放射学异常的患者效果最佳。1例患者发生了放射性滑膜切除术后滑膜炎并发症。
结论
放射性滑膜切除术是治疗血友病患者复发性关节积血的一种有效且安全的方法，尤其是对于那些关节无或仅有轻微放射学损伤的患者。
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