32P-胶体滑膜切除术治疗青少年血友病性关节炎的疗效

目的观察应用放射性核素32P-胶体关节腔内注射治疗青少年血友病性关节炎的疗效。方法对26例平均年龄16岁(11~21岁)的男性血友病性关节炎患者的26个病变关节进行首次32P-胶体关节滑膜切除,关节腔内注射平均剂量为2.1 mCi(1.0~3.0 mCi)。结果术后6个月,23例患者关节腔内出血量减少30%以上,治疗有效率达88.5%;平均出血频率从治疗前的1.9次/月下降为治疗后的0.3次/月,具有显著性差异(P<0.05);平均疼痛评分从治疗前的2.4下降为治疗后的1.4,具有显著性差异(P<0.05);16例(61.5%)患者治疗后关节活动度有改善。结论32P-胶体关节腔内注射治疗血友病性关节炎安全、简便、有效,无明显不良发应,是一种取代手术滑膜切除治疗青少年血友病性关节炎的良好方法。

Therapeutic response of radiosynovectomy with 32P colloid in haemophilic synovitis of adolescents

Objective To evaluate the efficacy of radiosynovectomy with 32P colloid in haemophilic synovitis of adolescents. MethodsRadiosynovectomy with 32P colloid was primary performed on 26 male haemophilic patients(26 joints),whose average age was 16 years(11 to 21 years).The average dose of 32P colloid was 2.1 mCi(1.0 to 3.0 mCi). Results After 6-month interval,haemarthrosis was reduced by no less than 30% in 23 patients,with a total efficacy of 88.5%.The mean frequency of haemarthrosis was reduced from 1.9 per month of presynovectomy to 0.3 per month of postsynovectomy(P<0.05).The average pain score was decreased from 2.4 to 1.4(P<0.05).Sixteen patients(61.5%) were observed improvement in the range of joint mobility. Conclusion Radiosynovectomy with 32P colloid in haemophilic synovitis is a safe,convenient and effective procedure with no severe side effects.Radioisotope synovectomy is useful to treat haemophilic synovitis of adolescents instead of surgical synovectomy.