^(32)P胶体滑膜切除术治疗血友病性关节炎的随访分析

A follow-up analysis of radiosynovectomy with ^(32)P colloid in hemophilic synovitis

目的:观察32P胶体滑膜切除术治疗血友病性关节炎的长期疗效及并发症。方法:对47例在我院接受32P胶体滑膜切除术治疗血友病性关节炎的患者进行随访,内容包括:对治疗的总体评价、治疗关节的疗效、并发症、治疗后是否输注因子进行预防、是否进行康复理疗。结果:47例患者85个关节接受治疗,随访时间为治疗后2~6.5年,出血频率减少30%以上的有54个关节,有效率为63.5%(54/85),27个关节随访时治疗已超过5年,有55.6%(15/27)关节持续5年以上有效。15例患者29个关节有预防性输注凝血因子,18个关节出血频率明显减少;32例患者56个关节治疗后无预防性输注凝血因子,12个关节出血频率明显减少,2组出血频率明显减少比较差异有统计学意义(χ2=13.818,P<0.01)。结论:32 P胶体滑膜切除术治疗血友病性关节炎长期疗效肯定,并发症轻,治疗后仍需定期输注凝血因子预防出血。

Objective：To observe the long-term therapeutic effect and complications of radiosynovectomy with32P colloid in hemophilic synovitis.Method：We followed up 47patients who accepted radiosynovectomy with 32P colloid in hemophilic synovitis,it included the overall evaluation,therapeutic effect,complications and discomfort,whether the injection of coagulation factor to prevent bleeding and whether the rehabilitation therapy.Result：A total of 85radioative synovectomies were performed in 47hemophilic patients,following by 2to 6.5years after treatment,the frequency of bleeding reduced by no less than 30%in 54joints,with a total efficacy rate 63.5%（54/85）.There were 55.6%（15/27）joints which had therapeutic effect for more than 5years.There were 18joints that the bleeding frequencies significantly decreased in prevention group which 15patients with 29treated joints accepted proplylactic infusion of coagulation factor,and there were only 12joints of that in non preventive group,which 32patients with 56treated joints,a significant difference was found in two groups（χ2=13.818,P〈0.01）.Conclusion：Radiosynovectomy with 32P colloid in hemophilic synovitis has a high effective rate in a long duration and light complications.After treatment,it is need to the regular injection of coagulation factor to prevent bleeding.