| 血友病性关节炎手术治疗的研究进展 |
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投稿时间：2020-07-21
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| 作者 | Author | 单位 | Unit | E-Mail |
| 沈绍宁 |
SHEN Shao-ning |
浙江中医药大学第一临床医学院, 浙江 杭州 310053 |
The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China |
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| 吴东晓 |
WU Dong-xiao |
浙江中医药大学第一临床医学院, 浙江 杭州 310053 |
The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China |
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| 童培建 |
TONG Pei-jian |
浙江中医药大学第一临床医学院, 浙江 杭州 310053
浙江中医药大学附属第一医院, 浙江 杭州 310006 |
The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China |
tongpeijian@163.com |
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| 期刊信息：《中国骨伤》2021年34卷，第9期，第820-825页 |
| DOI：10.12200/j.issn.1003-0034.2021.09.006 |
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| 手术治疗是目前血友病性关节炎的主要治疗方法，包括滑膜切除术、关节置换术、关节融合术。滑膜切除术适用于早期血友病性滑膜炎，分为放射性、化学性、关节镜、开放式。放射性滑膜切除术疗效肯定且副作用小，推荐为首选，但存在核素稀缺等问题；化学性滑膜切除术价廉且易操作，适合发展中国家开展，多次注射及注射后疼痛是其主要缺点；关节镜下滑膜切除术对晚期病变有显著疗效，但存在更高的手术相关风险；开放式手术创伤大、术后关节僵硬，现很少开展。关节置换术有效提高晚期患者的关节活动度，适用于高活动度要求关节；关节融合术虽有效改善症状但导致关节活动度丧失，适用于低关节活动度要求关节。血友病性关节炎的手术治疗存在开展术式单一，早期诊疗不及时，晚期疗效不理想等问题，其治疗应侧重于早期治疗，形成全程、系统的个体化治疗观念。 |
| [关键词]:血友病 关节炎 外科手术 综述 |
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| Progress on surgical treatment for hemophiliac arthropathy |
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| Abstract:Surgical treatment is the main treatment for hemophilia arthritis,including synoviectomy,joint replacement and joint fusion. Synoviectomy is suitable for early hemophilia synovitis,and is divided into radiation,chemical,arthroscopy,and open operation. Radionuclides were recommended as the first choice due to its positive efficacy and less side effects,but exsit some problems such as scarcity of nuclides. Chemical synoviectomy is cheap and easy to operate,which is suitable for developing countriesm,while mutiple doses and pain after injection are main fault. Synoviectomy under arthroscope has a significant effect on the advanced lesion,but has a higher surgical risk. Open surgery with severe trauma and postoperative joint stiffness,is rarely performed. Joint replacement could effectively improve range of motion in advanced patients and is suitable for joints with high range of motion. Arthrodesis are effective in improving symptoms but lead to loss of range of motion and are suitable for joints with low range of motion. Operation for hemophilia arthritis has some problems,such as single operation,untimely diagnosis and treatment in early stage,and unsatisfactory curative effect in late stage. In addition,the treatment of hemophilia arthritis should focus on the early treatment,the formation of the whole process,the system of individual treatment concept. |
| KEYWORDS:Hemophilia Arthritis Surgical procedured,opertaive Review |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 沈绍宁,吴东晓,童培建.血友病性关节炎手术治疗的研究进展[J].中国骨伤,2021,34(9):820~825 |
| 英文格式: | SHEN Shao-ning,WU Dong-xiao,TONG Pei-jian.Progress on surgical treatment for hemophiliac arthropathy[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(9):820~825 |
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