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  • Title: [Perioperative management of orthopaedic patients with hemophilia A].
    Author: Wu YG, Li XG, Zhang KN, Ren YJ, Li SF, Lu MY.
    Journal: Zhonghua Wai Ke Za Zhi; 2004 Dec 07; 42(23):1430-3. PubMed ID: 15733456.
    Abstract:
    OBJECTIVE: To discuss the perioperative management of hemophiliacs A with orthopaedic complications. METHODS: To regulate the injection of factor VIII concentrate in peroperative period by testing the level of factor VIII:C in 27 cases. The lever of factor VIII:C was improved to 30% - 50% at the day before the operation. To the severe patients, it was maintained at 58.5% - 89.3% during the operation and at 47.0% - 78.4% in postoperation. While to the gentle, it was maintained at 38.5% - 52.5% during the operation and at 29.2% - 52.3% in postoperation. The individualized surgical procedures were carried out, such as arthrocentesis, open knee synovectomy or arthroscopic synovectomy, evacuation or curettage of haematoma, debridements, internal fixation. RESULTS: All patients were cured in 14 - 105 days by regulating the injection of factor VIII during the peroperative period. The usage of factor VIII was 1 200 - 70 250 IU. CONCLUSION: While the hemophiliacs have orthopaedic complications, it is necessary to promise the factor VIII:C being maintained at the lever of hemostasis during the peroperative period. The hemophiliacs are endurable to the operation.
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