Prophylaxis And Relevant Factors In Moderate And Severe Hemophilia A In Nanchong

Objective: A retrospective study of prophylaxis was carried out from Affiliated Hospital of North Sichuan Medical College,to observe the treatment effects in 38 cases of moderate and severe hemophilia A in children,so that we can reach a further development of the comprehensive treatment of hemophilia.Methods: The clinical data were collected from inpatient cases and outpatient cases of hemophilia A in children,and the questionnaires(CHO-KLAT,Canadian Hemophilia outcomes—Kid's Life Assessment Tool,include the Chinese patient sheet and the Chinese kid's sheet)were complicated at the scene,part of the data form telephone interviews and medical records with unified tabulation.Results:1.The frequency of annual bleeding and annual joint bleeding in moderate and severe hemophilia A were significantly reduced after prophylactic therapy.The difference was statistically significant(P<0.05).2.Compared with the secondary prophylaxis and the tertiary therapy as well as the episodic treatment,there is a significant difference between the frequency of average annual total bleeding and annual joint bleeding after prophylactic treatment(P<0.05).Comparison was given in three groups: the difference between secondary prophylaxis and the tertiary therapy was statistically significant(P < 0.05),the same result was received in tertiary therapy and the episodic treatment(P < 0.05),while there was no statisticallysignificant difference between secondary prophylaxis and the episodic treatment(P > 0.05).3.Compared with the low-dose prophylaxis and on-demand treatment,there is a significant difference in reducing annual total bleeding and annual joint bleeding with standard-dose prophylaxis(P < 0.01).Both of the prophylaxis make a significant difference than on-demand treatment,P < 0.05 in the low-dose prophylaxis group,and P < 0.01 in the standard-dose prophylaxis group.4.The coagulation factor was given every three days had the best effect in reducing annual total bleeding and annual joint bleeding,there is a significant difference between once-a-week group,every ten days group and irregular group(P < 0.01).5.The sooner the beginning of prophylaxis,the better of the joint protection and the smaller probability of the target joint.6.The CHO-KLAT score showed that the children's sheet score was(54.09±7.12),the parent sheet score was(52.55 ± 5.56),the difference was statistically significant(P < 0.05).7.There is no significant correlation between parents' education level and the choice of prophylaxis or on-demand treatment.8.The prophylaxis of hemophilia was positively related to economic income.9.The prophylaxis of hemophilia was positively related to the frequency of publicity and education.Conclusion: The prophylaxis of hemophilia in children in Nanchong area has achieved initial success,the frequency of annual total bleeding,the annual joint bleeding and severe bleeding were significantly reduced,and thequality of life of the children was improved.However,the treatment is not yet adequate and standardized.Anyway,the economic pressure is the significant barrier to prophylaxis.Furthermore,the lack of laboratory equipment and specialist physicians as well as the adherence to medical treatment is another factor.There is a certain gap compared to the economy developed areas.Therefore,the prophylaxis of hemophilia in children need to be strengthened in the future.