马乐;范猛;姜文学;

• 1:天津市第一中心医院

摘要(Abstract)：

血友病性关节炎是血友病的主要并发症,对于膝关节功能影响较大,如果治疗不当有较高的致残率。治疗方法中,凝血因子替代治疗是血友病患者减少关节出血的有效手段,预防性输注凝血因子更是能减少血友病性膝关节炎的发病和延缓疾病进展;康复物理治疗和滑膜切除术等治疗方法改善膝关节状况的疗效逐渐被业界认可,为血友病性膝关节炎治疗提供了新的思路:康复理疗在血友病性膝关节炎早期保持关节活动度和肌肉力量。滑膜切除术可有效减少膝关节出血频率,缓解关节肿胀状况。全膝关节置换术是重度膝关节血友病性关节炎治疗的有效手段,可以减轻血友病性关节炎终末期的疼痛,恢复膝关节功能。各种治疗方法都有相应的适应证和利弊,本文将对血友病性膝关节炎治疗方法进行总结,并将最新研究进展进行归纳,为临床提供理论依据。

关键词(KeyWords)： 血友病;关节炎;全膝关节置换术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 马乐;范猛;姜文学;

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参考文献(References)：

• [1]Zhao H,Yang L,Long C,et al.Hemophilia care in China:review of care for 417 hemophilia patients from 11 treatment centers in Shanxi Province[J].Expert Rev Hematol,2015,8(4):543-550.
• [2]Groen W,van der Net J,Bos K,et al.Joint health and functional ability in children with haemophilia who receive intensive replacement therapy[J].Haemophilia,2011,17(5):783-790.
• [3]Zhang L,Li H,Zhao H,et al.Retrospective analysis of 1 312 patients with haemophilia and related disorders in a single Chinese institute[J].Haemophilia,2003,9(6):696-702.
• [4]Valentino LA,Mamonov V,Hellmann A,et al.A randomized comparison of two prophylaxis regimens and a paired comparison of on-demand and prophylaxis treatments in hemophilia A management[J].Thromb Haemost,2012,10(3):359-367.
• [5]Park YS,Shin WJ,Kim KI.Comparison of continuous infusion versus bolus injection of factor concentrates for blood management after total knee arthroplasty in patients with hemophilia[J].BMCMusculoskelet Disord,2017,18(1):356.
• [6]Boban A,Lambert C,Hermans C.The use of short-term central venous catheters for optimizing continuous infusion of coagulation factor concentrate in haemophilia patients undergoing major surgical procedures[J].Haemophilia,2015,21(5):364-368.
• [7]Oldenburg J.Optimal treatment strategies for hemophilia:achievements and limitations of current prophylactic regimens[J].Blood,2015,125(13):2038-2044.
• [8]Manco-Johnson MJ,Abshire TC,Shapiro AD,et al.Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia[J].N Engl J Med,2007,357(6):535-544.
• [9]Srivastava A,Brewer AK,Mauser-Bunschoten EP,et al.Guidelines for the management of hemophilia[J].Haemophilia,2013,19(1):1-47.
• [10]Jackson SC,Yang M,Minuk L,et al.Prophylaxis in older Canadian adults with hemophilia A:lessons and more questions[J].BMCHematol,2015,15(1):4.
• [11]Oldenburg J,Zimmermann R,Katsarou O,et al.Controlled,crosssectional MRI evaluation of joint status in severe haemophilia Apatients treated with prophylaxis vs.on demand[J].Haemophilia,2015,21(2):171-179.
• [12]Westberg M,Paus AC,Holme PA,et al.Haemophilic arthropathy:long-term outcomes in 107 primary total knee arthroplasties[J]Knee,2014,21(1):147-150.
• [13]Astermark J,Berntorp E,White GC,et a1.The Malmfi International Brother Study(MIBS):further support for genetic predisposition toinhibitor development in hemophilia patients[J].Hemophilia2001,7:267-272.
• [14]Astermark J.FVI inhibitors:pathogenesis and avoidance[J]Blood,2015,125:2045-2051.
• [15]徐卫群.血友病抑制物形成及治疗[J].中国小儿血液与肿瘤杂志,2016,21(1):9-10.
• [16]Saeki N,Mochizuki S,Fujii T,et al.Postsurgical coagulopathy in a hemophilia A patient with inhibitors:efficacy of recombinant factor VIIa[J].J Anesth,2014,28(4):621-624.
• [17]Hay CR,Di Michele DM.International Immune Tolerance Study The principal results of the International Immune Tolerance Study a randomized dose comparison[J].Blood,2012,119(6):1335-1344.
• [18]Pierstorff K,Seuser A,Weinspach S,et al.Physiotherapy home exercise program for haemophiliacs[J].Klin Padiatr,2011,223(3)189-192.
• [19]Simpson ML,Valentino LA.Management of joint bleeding in hemophilia[J].Expert Rev Hematol,2012,5(4):459-468.
• [20]Forsyth AL,Zourikian N,Valentino LA,et al.The effect of cooling on coagulation and haemostasis:should"Ice"be part of treatment of acute haemarthrosis in haemophilia[J].Haemophilia,2012,18(6):843-850.
• [21]Negrier C,Seuser A,Forsyth A,et al.The benefits of exercise for patients with haemophilia and recommendations for safe and effective physical activity[J].Haemophilia,2013,19(4):487-498.
• [22]Hermans C,De Moerloose P,Fischer K,et al.Management of acute haemarthrosis in haemophilia A without inhibitors:literature review,European survey and recommendations[J].Haemophilia2011,17(3):383-392.
• [23]Rodriguez-Merchan EC,Jimenez-Yuste V,Aznar JA,et al.Joint protection in haemophilia[J].Haemophilia,2011,17(Suppl 2)1-23.
• [24]Mulder K,Llinas A.The target joint[J].Haemophilia,2004,10(Suppl 4):152-156.
• [25]Wittmeier K,Mulder K.Enhancing lifestyle for individuals with haemophilia through physical activity and exercise:the role of physiotherapy[J].Haemophilia,2007,13(Suppl 2):31-37.
• [26]Souza JC,Simoes HG,Campbell CS,et al.Haemophilia and exercise[J].Int J Sports Med,2012,33(2):83-88.
• [27]Rodriguez-Merchan EC,De la Corte-Rodriguez H,JimenezYuste V.Joint aspiration of acute tense knee haemarthroses in adult haemophilia A patients[J].Thromb Res,2013,132(6)778-779.
• [28]Strawczynski H,Stachewitsch A,Morgenstern G,et al.Delivery of care to hemophilic children:home care versus hospitalization[J]Pediatrics,1973,51(6):986-991.
• [29]Verma N,Valentino LA,Chawla A.Arthroscopic synovectomy in haemophilia:indications,technique and results[J].Haemophilia2007,13(Suppl 3):38-44.
• [30]Roosendaal G,Te Koppele JM,Vianen ME,et al.Blood-induced joint damage:a canine in vivo study[J].Arthritis Rheum,1999,42(5):1033-1039.
• [31]De Almeida AM,de Rezende MU,Cordeiro FG,et al.Arthroscopic partial anterior synovectomy of the knee on patients with haemophilia[J].Knee Surg Sports Traumatol Arthrosc,2015,23(3):785-791.
• [32]Schneider P,Farahati J,Reiners C.Radiosynovectomy in rheumatology,orthopedics,and hemophilia[J].Nucl Med,2005,46(Suppl 1):48-54.
• [33]Siegel ME,Siegel HJ,Luck JV Jr.Radiosynovectomy's clinical applications and cost effectiveness:a review[J].Semin Nucl Med,1997,27(4):364-371.
• [34]Siegel HJ,Luck JV,Siegel ME,et a1.Hemarthrosis and synovitis associated withhemophilia:clinical use of P-32 chromic phosphate synoviorthesis for treatment[J].Radiology,1994,190:257-261.
• [35]Silva M,Luck JV,Leissinger C.Opinions on radiosynovectomy for chronic haemophilic synovitis:point/counterpoint[J].Haemophilia,2012,18(6):836-842.
• [36]Caruso I,Montrone F,Fumagalli M,et al.Rheumatoid knee synovitis successfully treated with intraarticular Rifamicin SV[J].Arthritis Rheum,1980,23(4):518-519.
• [37]史宏,徐鸣,李丹,等.利福平化学性滑膜切除术治疗血友病慢性滑膜炎[J].血栓与止血学,2014(5):42-44.
• [38]Bernal-Lagunas R,Aguilera-Soriano JL,Berges-Garcia A,et al.Haemophilicarthropathy:the usefulness of intra-articular oxytetracycline(synoviorthesis)in the treatment of chronic synovitis in children[J].Haemophilia,2011,17(2):296-299.
• [39]Fernández-Palazzi F,Cede?o M,Maldonado JC,et al.Chemical synoviorthesis with oxytetracycline clorhydrate(Emicine)in recurrent haemarthrosis[J].Haemophilia,2008,14(1):21-24.
• [40]Ali T,Abou Fakher FH,Schved JF.Chemical vs.radioactive synoviorthesis for treatment of chronic haemophilic synovitis:Syrian experience[J].Haemophilia,2016,22(6):573-575
• [41]Rodriguez-Merchan EC.Hemophilic synovitis of the knee:radiosynovectomy or arthroscopic synovectomy[J].Expert Rev Hematol,2014,7(4):507-511.
• [42]Rodriguez-Merchan EC,Corte-Rodriguez H,Jimenez-Yuste V.Radiosynovectomy in haemophilia:long-term results of 500 procedures performed in a 38-year period[J].Thromb Res,2014,134(5):985-990.
• [43]冯宾,翁习生,林进,等.初次全膝关节置换术后并发症及翻修手术的原因分析[J].中华外科杂志,2015,53(2):106-109.
• [44]Westberg M,Paus AC,Holme PA,et al.Haemophilicarthropathy:long-term outcomes in 107 primary total knee arthroplasties[J].Knee,2014,21(1):147-145.
• [45]Zingg PO,Fucentese SF,Lutz W,et al.Haemophilic knee arthropathy:long-term outcome after total knee replacement[J].Knee Surg Sports Traumatol Arthrosc,2012,20(12):2465-2470.
• [46]Strauss AC.Outcome after total knee arthroplasty in haemophilic patients with stiff knees[J].Haemophilia,2015,21(4):300-305.
• [47]Chiang CC,Chen PQ,Shen MC,et al.Total knee arthroplasty for severe haemophilicarthropathy:long-term experience in Taiwan[J].Haemophilia,2008,14(4):828-834.
• [48]Solimeno LP,Mancuso ME,Pasta G,et al.Factors influencing the long-term outcome of primary total knee replacement in haemophiliacs:a review of 116 procedures at a single institution[J].Br JHaematol,2009,145(2):227-234.
• [49]Hirose J,Takedani H,Koibuchi T.The risk of elective orthopaedic surgery for haemophilia patients:Japanese single-centre experience[J].Haemophilia,2013,19(6):951-5.35.
• [50]Mortazavi SM,Haghpanah B.Functional outcome of total knee arthroplasty in patients with haemophilia[J].Haemophilia,2016,22(6):919-924.
• [51]冯宾,翁习生,林进,等.血友病性骨关节病变的外科治疗策略[J].中华骨科杂志,2016,36(7):413-421.
• [52]孙铁铮,吕厚山.晚期类风湿关节炎合并膝关节强直或僵直畸形行人工膝关节置换术[J].中华关节外科杂志,2011,5(1):3-9.
• [53]Cho KY,Kim KI,Khurana S,et al.Computer-navigated total knee arthroplasty in haemophilicarthropathy[J].Haemophilia,2013,19(2):259-266.
• [54]Kim KI,Kim DK,Juh HS,et al.Robot-assisted total knee arthroplasty in haemophilicarthropathy[J].Haemophilia,2016,19(1):112-114.
• [55]Sheth DS,Oldfield D,Ambrose C,et al.Total knee arthroplasty in hemophilic arthropathy[J].J Arthroplasty,2004,19(1):56-60.2018-01-25