Radiosynovectomy in patients with chronic haemophilic synovitis: when is more than one injection necessary?
Radiosynovectomy in patients with chronic haemophilic synovitis: when is more than one injection necessary?
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DOI：
10.1111/j.1600-0609.2011.01583.x
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发表时间：
2011-05-01
影响因子：
3.1
通讯作者：
Jimenez-Yuste, Victor
中科院分区：
文献类型：
--
作者：
de la Corte-Rodriguez, Hortensia;Rodriguez-Merchan, Emerito-Carlos;Jimenez-Yuste, Victor
对诊断为慢性血友病滑膜炎的78例血友病患者的104个关节进行了156例放射滑膜切除术（RSs）。患者平均年龄为18岁。先前对同一组患者的研究表明，RS是治疗慢性血友病滑膜炎的有效方法，可能需要进行1-3次注射（RS-1, RS-2, RS-3），间隔6个月。这些研究还显示RS后显示最大改善的参数是疼痛和血液病，其次是世界血友病联合会（WFH）临床评分和肌肉力量和活动范围。这些研究还表明，进一步改善RS与患者的年龄、血友病的类型和严重程度、以前的血液学治疗方案（按需或预防性）、循环抑制剂的存在与否、患者以前的水平或活动（或不活动）、以前的关节病（关节退行性变）的存在与否无关。所使用的同位素（钇-90或铼-186）以及rs衍生并发症的外观或其他方面。在这项研究中，我们研究了治疗的关节类型和滑膜炎程度之间的潜在关系，并发现膝关节比肘部或踝关节需要更多的注射，更严重的滑膜需要更多的RS手术。
One hundred and fifty-six radiosynovectomies (RSs) were performed in 104 joints of 78 haemophilic patients diagnosed with chronic haemophilic synovitis. Mean patient age was 18 yr. Previous studies on the same group of patients indicated that RS is an effective procedure for treating chronic haemophilic synovitis, which may require the performance of 1-3 injections (RS-1, RS-2, RS-3), with a 6-month interval between them. Those studies also revealed that the parameters showing the greatest improvement after RS were pain and haemarthrosis, followed by the World Federation of Haemophilia (WFH) clinical score and muscle strength and range of motion. Such studies also demonstrated that the improvement achieved further to RS is independent of the patient's age, the type and severity of haemophilia, the previous haematologic treatment regime administered (on demand or prophylactic), the presence or absence of a circulating inhibitor, the patients' previous level or activity (or inactivity), the presence or absence of previous arthropathy (joint degeneration), of the isotope used (yttrium-90 or rhenium-186) and of the appearance or otherwise of RS-derived complications. In this study, we looked into the potential relationship between the type of joint treated and the degree of synovitis present with the need of one or more further RSs, and we found that the knee requires more injections than the elbow or the ankle and that the more severe synovites require a higher number of RS procedures.