CAJ | 학술논문

背景：目前国内外医疗机构大多围绕血友病关节置换术等手术方式进行技术层面研究和报道，但缺乏针对血友病性骨关节病围手术期并发症分析的介绍。 　　目的：了解血友病性骨关节病围手术期伤口并发症的发生情况。 　　方法：本文回顾性研究2000年1月至2014年8月在我院接受骨科手术治疗的101例血友病患者，分析围手术期伤口并发症发生情况、临床处理和转归。 　　结果：101例血友病患者共实施包括关节置换术、血友病假瘤切除术、跟腱延长术等骨科手术147例次。101例患者中5例出现伤口愈合不良，其中4例经伤口换药后延迟愈合，1例经VSD治疗配合伤口清创、植皮后痊愈；另外还有3例患者出现伤口感染，其中1例经保守治疗后痊愈，1例经伤口清创及皮瓣转移术后愈合，1例伤口迁延不愈。总的围手术期伤口并发症发生率为5.4%（8/147）。 　　结论：血友病性骨关节病围手术期出现伤口并发症风险较高，采取有效预防和处理措施可明显减少伤口并发症给患者带来的损害。
배경：목전국내외의료궤구대다위요혈우병관절치환술등수술방식진행기술층면연구화보도，단결핍침대혈우병성골관절병위수술기병발증분석적개소。 　　목적：료해혈우병성골관절병위수술기상구병발증적발생정황。 　　방법：본문회고성연구2000년1월지2014년8월재아원접수골과수술치료적101례혈우병환자，분석위수술기상구병발증발생정황、림상처리화전귀。 　　결과：101례혈우병환자공실시포괄관절치환술、혈우병가류절제술、근건연장술등골과수술147례차。101례환자중5례출현상구유합불량，기중4례경상구환약후연지유합，1례경VSD치료배합상구청창、식피후전유；령외환유3례환자출현상구감염，기중1례경보수치료후전유，1례경상구청창급피판전이술후유합，1례상구천연불유。총적위수술기상구병발증발생솔위5.4%（8/147）。 　　결론：혈우병성골관절병위수술기출현상구병발증풍험교고，채취유효예방화처리조시가명현감소상구병발증급환자대래적손해。
Background:Most researches and reports on hemophilia joint replacement focus on the surgical technology, but there lacks of analysis on perioperative complications of hemophilic osteoarthropathy. Objective:To investigate the occurrence of perioperative wound complications in haemophilia patients undergoing orthope-dic surgery. Methods:A total of 101 haemophilia patients who received orthopedic surgery in our hospital between January 2000 and Au-gust 2014 were enrolled in this retrospective study. The occurrence, treatment and prognosis of perioperative wound compli-cations were analyzed. Results:A total of 147 orthopedic surgeries were performed in the 101 patients, including joint replacement, resection of he-mophilia pseudotumor and Achilles' tendon lengthening. Five patients had poor wound healing (delayed union was achieved in 4 patients after dressing, another one was cured after VSD, debridement and skingrafting) and three patients had wound in-fection (full recovery was achieved in one patient after expectant treatment, one was cured after debridement and skingraft-ing, and the wound failed to heal in another one). The total incidence of perioperative wound complications was 5.4%(8/147). Conclusions:There is a high risk of perioperative wound complications in haemophilia patients undergoing orthopedic sur-gery. Effective preventive and treatment measures can significantly reduce the harm to patients from wound complications.