Perioperative management of orthopaedic patients with hemophilia A / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the perioperative management of hemophiliacs A with orthopaedic complications.</p><p><b>METHODS</b>To regulate the injection of factor VIII concentrate in peroperative period by testing the level of factor VIIIC in 27 cases. The lever of factor VIIIC 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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>While the hemophiliacs have orthopaedic complications, it is necessary to promise the factor VIIIC being maintained at the lever of hemostasis during the peroperative period. The hemophiliacs are endurable to the operation.</p>