骨关节病合并血友病甲的诊断与治疗
刘自立,尚希福,胡飞,朱亚林,段丽群,贺瑞
摘要(Abstract):
[目的]探讨骨关节病合并血友病甲患者的诊断和治疗方法。[方法]本院自2006年1月~2009年8月共收治21例骨关节病合并甲型血友病患者,21例患者先予替代治疗将八因子活性水平提升到20%以上后,均采用手术治疗,所有患者术后前3个月每月门诊随访1次,以后每2~3个月随访1次。现采用回顾性研究方法分析其临床特征和治疗方法。[结果]21例患者均获得随访,平均随访时间28个月。21例患者有11例有明显外伤史,有10例仅有轻微外伤史,其共同临床特征表现为损伤部位与暴力不成比例的剧烈肿胀和疼痛,首次诊断正确的有12例,误诊9例,误诊率43%。17例治愈,4例好转。19例患者切口一期愈合,2例二期愈合。膝关节血肿患者3例反复出血病史长者行滑膜切除术,术后存在不同程度的膝关节功能障碍,另外7例恢复较好,KSS评分术前(59.7±4.3)分,术后(79.5±6.9)分。[结论]骨关节病合并血友病甲的临床特征是损伤部位与暴力不成比例的剧烈肿胀和疼痛,在替代治疗的保障下,采用手术治疗可以取得较好的临床效果。
关键词(KeyWords): 血友病甲;骨科;诊断;治疗
基金项目(Foundation):
作者(Author): 刘自立,尚希福,胡飞,朱亚林,段丽群,贺瑞
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