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 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.</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 VIII:C being maintained at the lever of hemostasis during the peroperative period. The hemophiliacs are endurable to the operation.</p>