背景:获得性A型血友病,虽然在老年患者中并不常见,带来了重大的临床挑战,特别是与严重的肌肉骨骼并发症有关。作为肿瘤的血肿的潜在模拟进一步使诊断过程复杂化。
方法:一名85岁的男性,有遥远的高血压病史,良性前列腺增生,和右腹股沟疝,左下肢出现急性疼痛,功能限制,回肠和腋窝区的深部血肿。最初怀疑回肠有肉瘤病变,根据放射学发现,在组织病理学检查后被驳斥,证实了坏死出血组织的存在。患者接受了为期一个月的物理治疗方案,瞄准下肢肌肉,尤其是髋关节周围.
■表现的严重程度以及回肠前肌和股四头肌等重要肌肉的受累强调了全面康复的重要性。一致的治疗干预措施,针对肌肉力量和关节功能,HJHS证明了显著的改善,哈尔,和FISH分数。多学科方法,涉及血液学,康复,和支持性措施,在确保患者整体康复方面至关重要。
结论:老年人获得性A型血友病需要综合护理方法,包括准确的诊断和量身定制的治疗干预措施。这个案例强调了专用物理治疗在管理这种出血性疾病的肌肉骨骼影响方面的转化潜力,强调早期干预和综合护理的价值。
BACKGROUND: Acquired haemophilia-A, although uncommon in elderly patients, poses significant clinical challenges, especially when associated with profound musculoskeletal complications. The potential mimicry of hematomas as tumors further complicates the diagnostic process.
METHODS: An 85-year-old male, with a remote history of hypertension, benign prostatic hyperplasia, and right inguinal hernia, presented with acute pain in the left lower limb, functional limitation, and deep hematomas in the ileopsoas and axillary region. Initial suspicions of a sarcomatous lesion in the ileopsoas, based on radiological findings, were refuted following histopathological examinations, which confirmed the presence of necrotic hemorrhagic tissue. The patient underwent a one-month physical therapy regimen, targeting lower extremity muscles, especially around the hip joint.
UNASSIGNED: The severity of the presentation and the involvement of vital muscles like the ileopsoas and quadriceps underscored the importance of comprehensive rehabilitation. Consistent therapeutic interventions, targeting muscle strength and joint function, demonstrated marked improvement as evidenced by the HJHS, HAL, and FISH scores. The multidisciplinary approach, entailing hematological, rehabilitative, and supportive measures, was paramount in ensuring holistic patient recovery.
CONCLUSIONS: Acquired haemophilia-A in the elderly necessitates an integrative care approach, encompassing accurate diagnosis and tailored therapeutic interventions. This
case emphasizes the transformative potential of dedicated physiotherapy in managing the musculoskeletal implications of this bleeding disorder, underscoring the value of early intervention and comprehensive care.