牙齦異常出血──出血性疾病

Bleeding Disorders with Gingival Hemorrhage

王韻涵(Yun-Han Wang) ； 林益弘(Yi-Hung Lin) ； 陳佳菁(Chia-Ching Chen) ； 盧俊泰(Chun-Tai Lu)

《臺灣牙周病醫學會雜誌》 24卷2期 (2019/12) Pp. 146-156

https://doi.org/10.6121/TAP.201912_242.0008

摘要

牙齦炎或牙周炎是造成牙齦出血最常見的原因，當身體伴隨有其他全身性因素時，例如先天性或後天性出血性疾病，會使原本發炎或紅腫的牙齦更易發生異常流血的情形。治療前應先排除患者是否有潛在血液因素，必要時可先會診內科醫師或血腫科醫師，確立診斷並給予適當牙科治療前處置措施，例如預先輸注血小板或凝血因子等，如此才能給予病患安全且適當的治療。本文提出三例不同類型出血性疾病：白血病、特發性血小板減少紫斑症、凝血因子缺乏，合併牙齦異常出血的病例，及臨床上相對應的處置措施。

關鍵字

牙齦異常出血 ； 血管性異常 ； 血小板異常 ； 凝血異常 ； 纖維蛋白溶解異常

並列摘要

Gingivitis and periodontitis are the most common causes of gingival bleeding. In patients with inherited or acquired bleeding disorders, inflamed and hyperemic gingival tissue are at increased risk of bleeding. The dental professionals must be aware of the problems of hemostasis, whether is the major cause of gingival hemorrhage. Consultation with the physician or the hematologist may be essential. Patient with bleeding disorders may require hematologic coverage or other managements for necessary dental treatment. Detailed evaluation and proper preparation ensure the safety of treatment for patient with bleeding disorders. In this review article, we summarized all types of bleeding disorders and present 3 cases of bleeding disorders with gingival hemorrhage: leukemia, idiopathic thrombocytopenic purpura, coagulation factor deficiencies.

並列關鍵字

gingival hemorrhage ； vascular disorders ； platelet disorders ； coagulation disorders ； fibrinolytic disorders