BMJ Best Practice
最后审核时间: 十月 2018
最近更新时间: 一月 2018

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 复发性或重度出血病史
  • 肌肉出血
  • 颅内出血

其他诊断因素

  • 过度淤青/血肿
  • 疲乏
  • 月经过多和手术操作或分娩后出血(女性携带者)
  • 广泛的皮肤紫癜(获得性血友病)

危险因素

  • 血友病家族史(先天性血友病)
  • 男性(先天性血友病)
  • 60 岁以上(获得性血友病)
  • 自身免疫性疾病、炎症性肠病、糖尿病、肝炎、妊娠、产后或恶性肿瘤(获得性血友病)

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 活化部分凝血活酶时间 (aPTT)
  • 混合试验
  • 血浆 VIII 和 IX 因子检测
全部具体信息

需要考虑的检查

  • 头部或颈部 CT
  • 头部或颈部 MRI
  • 腹部超声或腹腔盆腔 CT 扫描
  • 食管胃十二指肠镜检查 (OGD) 或结肠镜检查
全部具体信息

治疗流程

贡献者

Clinical Professor

Departments of Medicine, Pediatrics and Oncology

Cumming School of Medicine

University of Calgary

Calgary

Canada

利益冲突披露
M-CP is on advisory boards for Biogen-Idec, CSL-Behring, Novo Nordisk, Pfizer, Bayer, Baxalta, and Octapharma , he has been sponsored as a speaker by Pfizer, Bayer, and Novo Nordisk , and has done consulting work for Spark Therapeutic Inc. M-CP has received grant funding from CSL-Behring and Bayer, and has participated in sponsored research for CSL-Behring. M-CP is an unpaid volunteer for the World Federation of Hemophilia.

Clinical Assistant Professor

Department of Medicine

Cumming School of Medicine

University of Calgary

Calgary

Canada

利益冲突披露
AL has received fellowship training funding from the Bayer Hemophilia Award program. Her research project received peer-reviewed grant support from Canadian Hemophilia Society and Pfizer's Care Until Cure award. AK received investigator-initated research funding from Biogen. She has also served on an advisory board for Pfizer, and received travel funds from Baxalta.

Professor Poon and Dr Lee would like to gratefully acknowledge Dr Nigel S. Key, Dr Paul Giangrande, Dr Nidra I. Rodriguez, and Dr W. Keith Hoots, the previous contributors to this topic. NSK has undertaken paid consultancy for Baxter Biosciences, Novo Nordisk, CSL Behring, and Bayer. He has received grant funding from Baxter. PG has undertaken paid consultancy and/or received lecture fees from the following companies involved in haemophilia care: Bayer, CSL Behring, NovoNordisk, Pfizer/ BPL, Octapharma, Biogen Idec, and Biotest. NSK, NIR, and WKH are authors of reference(s) cited in this monograph.

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The Mary Weinfeld Professor of Clinical Research in Hemophilia

Mount Sinai School of Medicine

New York

NY

利益冲突披露
LA declares that he has no competing interests.

Associate Professor of Medicine

Innsbruck Medical University

Innsbruck

Austria

利益冲突披露
CP declares that he has no competing interests.

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