Gerster J C, Wauters J P, Waldburger M, Saudan Y
Schweiz Med Wochenschr. 1977 Aug 20;107(33):1170-2.
Three patients with hemarthrosis complicating anticoagulant therapy are described. Two had acute hemarthrosis of the knee joint occurring during long term oral anticoagulant therapy for cardiovascular disorders. Joint symptoms disappeared rapidly after arthrocentesis and diminution of the dose of oral anticoagulant medication. The third patient has been on chronic hemodialysis for the last three years. After 2 years of this therapy he developed periarthritis of the right shoulder, followed suddenly by hemarthrosis of the right shoulder which remained symptomatic for 9 months in spite of several joint aspirations and reduction in the dosage of heparin administered during hemodialysis. Resolution of the hemarthrosis of the right shoulder occurred only when the vascular access for the dialysis sessions was displaced from the right to the left forearm. It is assumed that there was communication in the venous draining territories of the arterio-venous fistula and the shoulder articulation.
本文描述了3例因抗凝治疗并发关节积血的患者。其中2例在长期口服抗凝药治疗心血管疾病期间出现膝关节急性积血。关节穿刺及减少口服抗凝药剂量后，关节症状迅速消失。第3例患者在过去3年中一直进行慢性血液透析。在这种治疗2年后，他出现了右肩关节周围炎，随后突然发生右肩关节积血，尽管进行了几次关节穿刺并减少了血液透析期间肝素的给药剂量，但仍有症状9个月。仅当透析疗程的血管通路从右侧移至左前臂时，右肩关节积血才得以消退。推测动静脉瘘的静脉引流区域与肩关节之间存在交通。
