خلفية البحث: يعد الناعور من الاضطرابات النزفية الشائعة، كما تعد الإصابة المفصلية السبب الرئيسي للإعاقة عند هؤلاء المرضى، لذلك ركزت العلاجات و الدراسات جميعها على كيفية تدارك الإصابة قبل حدوثها و طرائق الوقاية منها. و أثبتت الدراسات أهمية استئصال الغشاء الزليل كونه مصدر النزف و التخريب المفصلي لاحقاً، و يتم ذلك بعدة طرائق منها الاستئصال الكيماوي للغشاء الزليل بحقن مواد تليفه كالصادات و منها الريفامبيسين الذي أثبتت عدة دراسات تأثيره في إنقاص الألم و تحسين حركة المفصل.
هدف الدراسة: هدفت هذه الدراسة المستقبلية المجراة إلى معرفة مقدار فائدة هذا الإجراء و أمانه عند عينة من مرضى الناعور في سورية.
الخلاصة: يعد استئصال الغشاء الزليل الكيماوي بحقن الريفامبيسين علاجاً فعالاً و آمناً و غير مكلف عند مرضى الناعور.
Background: Many options are available for the treatment of synovitis or target joint in hemophilia to prevent recurrent bleeding and further joint destruction when conservative therapy fails such as chemical synovectomy. Chemical synovectomy with Rifampicin has been used for many years in several clinical trials with good results and without serious complications.
Objective :evaluate the safety and the efficacy of this procedure in the Syrian hemophilic patients.
Conclusion: chemical synovectomy with rifampicin is a good treatment, cheap and safe in hemophilic patients.
References used
Mannucci, PM, Tuddenham, EG. The hemophilias--from royal genes to gene therapy. N Engl J Med 2001; 344:1773
Rosendaal, F, Aledort, LM, et al. Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Thrombosis and Haemostasis. Factor VII and Factor IX Subcommittee. Thromb Haemost 2001; 85:560
Nienhuis, AW. Development of gene therapy for blood disorders. Blood 2008; 111:4431
Shetty, S, Vora, S, Kulkarni, B, et al. Contribution of natural anticoagulant and fibrinolytic factors in modulating the clinical severity of haemophilia patients. Br J Haematol 2007; 138:541
Van Dijk, K, Van Der, Bom JG, Fischer, K, et al. Do prothrombotic factors influence clinical phenotype of severe haemophilia? A review of the literature. Thromb Haemost 2004; 92:305
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