点击上方蓝字“知力医学”一起探索!

谭明珠1，詹昱1，曲佳1，冯可欣1，杨郁青1，陈燕梅1，冯莹2

1.，广东省广州市，医院血液内科

2.，广东省广州市，广州医院血液内科

摘要目的：探讨血友病A合并泌尿系结石及血尿患者的综合治疗。方法：回顾性分析1例血友病A合并泌尿系结石及血尿患者的临床资料，并复习相关文献。结果：患者诊断血友病A合并泌尿系结石及血尿，接受凝血因子替代治疗及多次手术治疗，替代治疗过程出现高滴度凝血因子抑制物，联合旁路治疗止血，最终经过综合治疗后血尿缓解、泌尿系梗阻解除、肾功能改善。结论：部分血友病A合并血尿患者单纯替代治疗疗效欠佳，需联合手术治疗止血及解除梗阻，围手术期充分替代治疗，必要时联合旁路治疗，可顺利完成手术。替代治疗过程注意监测抑制物滴度，以便及早发现和及时处理抑制物。

关键词：血友病A；泌尿系出血；泌尿系结石；治疗

HemophiliacAwithUrolithiasisandHaematuria:ACaseReportandLiteratureReview

TANMing-zhu1,ZHANYu1,QUJia1,FENGKe-xin1,YANGYu-qing1,CHENYan-mei1,FengYing2

1.DepartmentofHematology,GuangzhouTwelfthPeople’sHospital,Guangzhou,China

2.DepartmentofHematology,TheSecondAffiliatedHospitalofGuangzhouMedicalUniversity,Guangzhou,China

AbstractObjectiveToresearchtheintegratedtreatmentinhemophiliacApatientswithurolithiasisandhematuria.MethodsAcaseofhemophiliacAwithurolithiasisandhaematuriainamalepatientwasretrospectivelystudied.Therelatedliteraturewasreviewed.ResultsApatientdiagnosedwithhemophiliacAwithurolithiasisandhaematuriareceivedcoagulationfactorreplacementtherapyandthreesurgicaloperations.HighdegreeofinhibitorsofcoagulationFactorⅧwasdetectedafterreplacementtherapy.Thenthepatientwastreatedwithbypassdrugsforhomeostasis.Withintegratedtreatment,theremissionofhaematuria,reliefofurinaryobstructionandimprovementofrenalfunctionwasachieved.ConclulsionsTheout