利福平化学性滑膜切除术治疗血友病慢性滑膜炎

目的 了解利福平化学性滑膜切除术对血友病慢性滑膜炎的疗效.方法 报道成都市妇女儿童中心医院首例用利福平化学性滑膜切除术治疗血友病慢性滑膜炎并进行文献复习.患儿9岁,诊断为血友病甲（重型）,左膝关节慢性滑膜炎.坐轮椅,左膝关节明显肿胀、压痛,关节活动明显受限.入院后输注FⅧ,使FⅧ活性＞30％,立即在B超引导下行关节内注射利福平,每周1次,共9次.结果 随访3年,膝关节外观正常,行走及常规活动正常,左膝关节未再发生出血事件.结论 利福平用于化学性滑膜切除术,控制出血疗效好,操作方便,药源丰富,价格低廉,尤其适用于儿童.

Chemical Synovectomy with Rifampicin for Chronic Hemophilic Arthropathy

Objective To investigate the effect of chemical synovectomy with rifampicin for chronic hemophilic arthropathy.Methods To report the first chronic hemophilia synovitis treated by chemical synovectomy with rifampicin in our hospital,then literatures were reviewed.The patient was a 9 years old boy,diagnosed as severe hemophilia A,chronic synovitis.The patient was in wheelchair all the time,with his left knee joint swelled,tenderness obviously,the ranges of motion were limited.Patient received a bolus injection of FⅧ concentrate to achieve a factor level of 30％ before the procedure,then intra-articular rifampicin injection under ultrasound,once a week,for nine weeks.Results Followed-up for 3 years,the appearance of knee joint was normal,walking and daily living activity was normal,no bleeding episode.Conclusion Chemical synovectomy with rifampicin appears to be efficient,inexpensive,and simple and also especially practical in children.