CAJ | 학술논문

目的：探讨血友病合并骨折围手术期凝血因子替代治疗方法与安全性。方法5例合并骨折的血友病患者在血液内科的配合下，对患者实施手术治疗骨折，平均随访9个月。根据《血友病诊断与治疗中国专家共识》，围术期行凝血因子Ⅷ和御活性水平监测，进行因子Ⅷ(冻干人凝血因子Ⅷ)或因子Ⅸ(凝血酶原复合物)的替代治疗。结果本组5例血友病患者，围手术期应用凝血因子进行常规替代治疗，均安全度过围手术期，术中、术后无血肿、感染。但有一例股骨干骨折钢板固定后术后4个月再次骨折，经保守治疗骨愈合。结论凝血因子的替代治疗和凝血因子水平监测是保证血友病合并骨折手术治疗成功的关键。
목적：탐토혈우병합병골절위수술기응혈인자체대치료방법여안전성。방법5례합병골절적혈우병환자재혈액내과적배합하，대환자실시수술치료골절，평균수방9개월。근거《혈우병진단여치료중국전가공식》，위술기행응혈인자Ⅷ화어활성수평감측，진행인자Ⅷ(동간인응혈인자Ⅷ)혹인자Ⅸ(응혈매원복합물)적체대치료。결과본조5례혈우병환자，위수술기응용응혈인자진행상규체대치료，균안전도과위수술기，술중、술후무혈종、감염。단유일례고골간골절강판고정후술후4개월재차골절，경보수치료골유합。결론응혈인자적체대치료화응혈인자수평감측시보증혈우병합병골절수술치료성공적관건。
Objective To study the method and safety of coagulation factor replacement in patients having fracture with hemophilia. Methods Five male hemophilia patients with fractures were treated, and the mean follow-up period was 9 months. Under the cooperation with the hematology department. Monitored levels of factors Ⅷ and Ⅸ perioperatively, and established routine process of factor replacement, according to the China guideline of Hemophilia dialogue and tre atme nt. Results Hemophilic patients who had undergone therapy of perioperative coagulation factor replacement could suffer treatment of fractures. All patients had no complications such as hematoma, infection. But one patient firstly accepted operation, after 4months, the plate was broken, proformed conservative treatment. Conclusion Coagulation factor replacement and monitoring of coagulation factor levels are the key to the success of treament in hemophilic fracture patients.