Internal bleeding, which may indicate hemophilia

Internal bleeding usually occurs in hemophilia. Internal bleeding in hemophilia patients usually includes hematuria, gastrointestinal bleeding, and intracranial bleeding. Today we will mainly discuss the causes, symptoms, and treatments of these three diseases.

1. Hematuria in hemophilia

1. Causes of bleeding: Hematuria is not common in hemophilia, but it can occur spontaneously or after injury, or it can be caused by damage to the urinary and reproductive systems.

2. Symptoms: Bright red urine, usually painless, can lead to significant anemia;

3. Treatment: If it is mild/painless hematuria, transfuse coagulation factors and actively replenish fluids for 2-5 days, and monitor hemoglobin; if it is severe/painful hematuria, use replacement therapy as soon as possible, increase the dosage, and increase the factor level to 30-50%, continue for 3-5 days, and if necessary, blood transfusion.

4. Notes: (1) Severe hematuria is not suitable for home treatment and needs to be treated by a specialist in a specialized hospital;

• (2) Anti-fibrinolytic drugs, such as hexaaminoacetic acid, are prohibited;

• (3) In case of recurrent/persistent hematuria, a urinary system examination is required to confirm whether there are any local pathological abnormalities.

2. Gastrointestinal bleeding in hemophilia

1. Causes of bleeding: usually due to local injury, such as gastric ulcer, polyp, hemangioma;

2. Symptoms: It may manifest as vomiting blood, blood in the stool or black stool, which can quickly cause the patient to suffer from anemia or even shock.

3. Treatment: Immediate replacement therapy is performed to increase the coagulation factor level to 50-80% until the bleeding is controlled. The treatment is generally maintained for 3-7 days. If necessary, blood transfusion is performed. Endoscopy/angiography and other examinations should be used with caution. Antifibrinolytic drugs may be helpful. Generally, drugs for treating gastric diseases should be used under the guidance of a doctor to inhibit gastric acid and protect the gastric mucosa.

4. Notes:

(1) Severe hematuria is not suitable for home treatment and needs to be treated by a specialist in a specialized hospital;

(2) Patients with recurrent gastrointestinal bleeding should undergo liver function tests and viral load tests to confirm whether they have hepatitis C.

(3) Pay attention to diet. Do not eat or drink for 24 hours after bleeding. After the bleeding stops, you should also gradually transition from liquid food to semi-liquid food to normal food. The diet should be "warm, soft, light, vegetarian, and fresh".

3. Central nervous system bleeding in hemophilia

1. Cause of bleeding: This is the most serious acute complication. The bleeding may be subdural/intraventricular/subarachnoid. It may also occur spontaneously but is usually secondary to injury. Sometimes the cause is unknown. The onset of symptoms after injury can be delayed for several days.

2. Symptoms: headache, nausea, vomiting, which may be accompanied by local defects, epilepsy or increased intracranial pressure, and even blindness.

IV. Notes:

(1) Go to a regular specialist hospital for imaging examination in time to determine the type and extent of the disease; home treatment is not suitable.

(2) Follow the doctor's instructions and take other medical measures (anti-edema, anti-convulsion, anti-fibrinolytic drugs); if necessary, surgical intervention (make the factor level reach 80-100% before surgery);

(3) If necessary, healing can be followed by secondary prevention to avoid recurrent episodes and other sequelae;

(4) Take good rest and avoid overwork and staying up late. Keep a happy and stable mood. Pay attention to the prevention and treatment of high blood pressure and cardiovascular and cerebrovascular diseases.