• 근관절건강학회지
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• 제11권2호
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• pp.119-126
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• 2004

Purpose: The purpose of this study was to identify health problem and joint bleeding, disability according to severity in patients with hemophilia. Method: The research design was survey study for conformed severity in patients with hemophilia, health problem and bleeding of joint and degree of limitation. The subjects were 186 men in patients with hemophilia by convenience sampling. These results were analyzed statistically by frequency, percentage, t-test, chi-square. Result: 1. Health problem of severe hemophilia patients were significantly higher than moderate group(t=3.17, p=.002). A severe hemophilia patients were significantly higher than moderate group in health problem of socio-psychological, emotional, physical, interpersonal. 2. There was relation between severity and the frequency of bleeding($X^{2}=7.642$, p=.054). 3. A severe hemophilia patients were more than moderate group in disability of ankle joint(t=2.52, p=.013). Conclusion: A severe hemophilia patients has more severe problems than moderate patient in case of health problem, joint bleeding and degree of disability.

• 성인간호학회지
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• 제14권4호
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• pp.635-644
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• 2002

Purpose: This research was done to establish a theoretical foundation for the adjustment process of patients with hemophilia. Method: For this study, 14 patients with hemophilia participated. The data was collected through the in-depth interviews and analysed in terms of Strauss and Corbin's grounded theory methodology. Result: The core category was identified with "uncertainty". The adjustment process was classified into two stages: the 'unstable stage' before the moment they learn about the Hemophilia Foundation and the 'stable stage' since then. The two stages were further divided into four groups, namely 'the stage of isolation ', 'the stage of maintaining survival', 'the stage of pursuing hope', 'the stage of ambivalence'. The categories of these stages include a series of subcategories to describe the adjustment of patients. The quality of life for these patients has increasingly improved based on support from hemophiliac organizations. But due to the uncertainty of disease, the patients have four stages of adjustment process from the stage of isolation to that of ambivalence and might turn to feedback. Conclusion: Therefore the nursing interventions reflecting adjustment process of patients with hemophilia should be developed.

• 기본간호학회지
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• 제7권1호
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• pp.30-41
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• 2000

This study was done to provide a firsthand description and analysis of phenomenological data of the singular, subjective and lived experience of patients with hemophilia. Sixe patients suffering from hemophilia were selected for this study. Data were collected from May to August, 1999 through in-depth interviews. The phenomenological method described by Colaizzi was used for the phenomenogical analysis of the data. After transcribing the recorded interview, the researchers read the data repeatedly to identify significant statements, restated them succinctly, and then formulated meanings, themes, theme clusters, and categories. The formulated meanings were grouped into six categories : fear, loneliness, frustration, sypmtoms of hemophilia, reception of support, and commitment. An exhaustive description of the experience of hemophilia can be deduced from this study. It is as follows: even though patients with hemophilia feel fear, loneliness and frustrations and suffer from symptoms of their disease such as bleeding, pain and functional disorders, they commit themselves to the maintenance of good health and enthusiastic life style with the help of support resources such as family members.

• 성인간호학회지
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• 제18권1호
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• pp.71-80
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• 2006

Purpose: This study was to investigate the factors influencing the quality of life of patients with hemophilia and to provide the data for health promoting intervention in order to improve their quality of life. Method: The subjects of this study were involved 186 male patients with hemophilia by convenience sampling. These results were analyzed statistically by frequency, percentage, t-test, ANOVA, Pearson Correlation Coefficient, and Stepwise multiple regression. Results: There were significant differences in the quality of life according to the frequency of bleeding. Quality of life showed negative relationships and health problems, bleeding, limitation of joint motion, and depression with stepwise Multiple Regression analysis for quality of life revealed that the most powerful predictor was depression. Depression, health problem, and limitation of joint motion accounted for 64.6% of the variance in the quality of life of patients with hemophilia. Conclusion: Therefore it is necessary to develop nursing interventions with these variables to increase the quality of life for patients with hemophilia.

• 근관절건강학회지
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• 제13권2호
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• pp.119-129
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• 2006

Purpose: The purpose of this study was to analyze current treatments and characteristics of patients with hemophilia. Method: research design is a descriptive study exploring the current treatments, accompanied disorders, features related to the disease and subjects' social-demographic characteristics. The sample consisted of 218 hemophilia patients registered at Korea Hemophilia Foundation. Results: 80.3% of the subjects were diagnosed of this disease before the age of 10. 64.7% of them had a hemophilia familial history. 74.3% of them had disabilities. Main characters related to the disease were lack of the 8th factor and bleeding tendencies. Levels of severity had significant relationship with the number of hemorrhagic experiences. A common comorbidity found was hepatitis C. A treatment agent frequently use was GREENMONO INJ. and most patients injected it by themselves. 47.7% of the subjects used a dosage of 100 unit, and 45.4% of them injected to once a week. Conclusion: These data will be used as valuable knowledge for planning a patient care and managing their symptoms.

• Clinical and Experimental Pediatrics
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• 제56권7호
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• pp.291-297
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• 2013

Purpose: The aim of this study was to investigate prophylactic treatment effects in Korean patients with severe hemophilia A. Methods: A prospective study of 32 severe hemophilia A patients was conducted with the approval of the Institutional Review Board at the Eulji University Hospital. Two patients received primary prophylaxis; whereas, the other 30 patients were divided into 2 groups-secondary prophylaxis (n=15) and on-demand (n=15)-on the basis of their consent for secondary prophylaxis. A 20-25 IU/kg dose of factor VIII concentrate was administered to the primary and secondary prophylaxis group patients every 3 days for 1 year. The prophylactic effect was evaluated by observing changes in the Pettersson scores, annual number of total and joint bleeds, and factor VIII consumption for 1 year. Results: No moderate or severe bleeding was observed, and the Pettersson scores remained unchanged during the prophylaxis period in the patients who received primary prophylactic treatment. After the treatment was changed from on-demand to secondary prophylaxis, the annual number of total and joint bleeds in the secondary prophylaxis group decreased by $64.4%{\pm}13.0%$ and $70.0%{\pm}15.2%$, respectively. The average increase in Pettersson scores within 1 year was $0.5{\pm}0.8$ and $1.3{\pm}1.1$ in the secondary prophylaxis and on-demand groups, respectively. Prophylactic effects were also observed in patients >17 years who had nearly the same initial Pettersson scores. Conclusion: Intermediate-dose prophylactic treatment may delay hemarthropathy progression and prevent its occurrence in Korean severe hemophilia A patients.

• Journal of Genetic Medicine
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• 제7권1호
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• pp.1-8
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• 2010

Hemophilia A is a sex-linked recessive coagulation disorder associated with diverse mutations of the factor VIII gene and a variety of phenotypes. The type of mutation involved dictates the activity of factor VIII, and in turn the severity of bleeding episodes and development of alloantibodies against factor VIII (inhibitors). Missense mutations are the most common genetic risk factors for hemophilia A, especially mild to moderate cases, but carry the lowest risk for inhibitor development. On the other hand, intron 22 inversion is the most common mutation associated with severe hemophilia A and is associated with high risk of inhibitor formation. Large deletions and nonsense mutations are also associated with high risk of inhibitor development. Additional mutations associated with hemophilia A include frameshift and splice site mutations. It is therefore valuable to assess the mutational backgrounds of hemophilia A patients in order to to interpret their symptoms and manage their health problems.

• 대한장애인치과학회지
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• 제14권2호
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• pp.102-105
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• 2018

중등도의 혈우병 A 환아와 중증의 혈우병 B 환아가 응고인자 투여 후 전신마취 하에 각각 매복 과잉치 발거술 및 다수 유치의 우식치료를 받았다. 이와 같이 혈우병 환자의 치과치료 시에는 부족한 응고인자를 보충해주는 등의 응고인자 수준의 관리와 복잡한 의과적 처치 및 술 후 관리가 요구된다. 또한 치과치료 시 출혈을 유발되지 않도록 주의해야 하며 응급 상황 등에 대비하여 국소적 지혈 방법 등을 숙지하고 있는 것이 필요하다.

• Clinical and Experimental Pediatrics
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• 제51권12호
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• pp.1359-1362
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• 2008

혈우병 환자에서 가장 효과적인 치료 방침은 응고 인자의 보충으로, 그를 위해 안전하고 오래 사용할 수 있는 정맥 확보가 필요하다. 그러나 중심 정맥으로의 port는 전신 마취와 일정한 입원이 필요하고, 혈우병 환자에서 시행할 경우 보험 삭감의 문제도 있다. 본 저자는 두 명의 중증 혈우병 항체 환자에게 말초 삽입 중심 정맥관을 삽입하였다. 환자들은 잦은 출혈 소견 때문에 응고 인자를 투여 받았으며, 그로 인하여 혈관 확보에 어려움이 있었다. 환자 나이는 7세와 11세였다. 제 8 응고 인자 활성도는 모두 1% 이하였으며, 제 8 응고 인자 항체 수치는 각각 160과 26.3 BU/mL였다. 말초 삽입 중심 정맥관은 초음파 인도 하에, 외래에서, 국소 마취로 쉽게 삽입되었다. 말초 삽입 중심 정맥관 삽입은 잦은 출혈을 보이는 혈우병 환자에게 사용해 볼 수 있는 방법이다.

• Archives of Plastic Surgery
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• 제39권2호
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• pp.150-153
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• 2012

Hemophilia B is a rare blood coagulation disorder. Complications such as bleeding and hematoma can cause necrosis of flaps, wound disruption, and the disturbance of wound healing. In particular, guidelines for flap operations in hemophilia B patients have still not been defined, and case reports are rare. We reconstructed the heel of a 41-year-old male hemophilia B patient using a reverse sural artery flap operation. The patient presented with mild hemophilia, having 27% of the normal value of coagulation factor IX. Coagulation and the changing value of the coagulation factor were regularly measured, and 70% of the normal value of coagulation factor IX was maintained through the injection of recombinant coagulation factors and antihemorrhagics. Hematoma developed twice (postoperative day [POD] 5 and POD 7) and in each case the hematoma was removed. Injections of recombinant coagulation factors and antihemorrhagics were continuously administered until postoperative week 2. When the coagulation factors were within normal ranges. In this article, a hemophilia B patient underwent reverse sural artery flap surgery and the healing progress was analyzed. We conclude that higher than baseline levels of coagulation factors are needed for successful healing in reverse sural artery flap surgery.