牙齦異常出血：診斷與治療

Diagnosis and Treatments of 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1期 (2019/05) Pp. 61-70

https://doi.org/10.6121/TAP.201905_241.0007

摘要

臨床上當遇到病患因牙齦異常出血前來求診時，在給予治療之前，應先詳細詢問全身性疾病史、家族史、用藥史及過往異常流血的相關經驗。口內檢查需留意口腔局部因素是否與出血情形相符合，若不相符合，則須懷疑是否伴隨有未知的血液方面問題，可藉由抽血檢驗初步判定，必要時會診相關科別確立診斷並給予相對應的處置。從多數臨床個案治療結果顯示，縱使是有複雜的醫療病史，只要口腔清潔維護良好，去除局部發炎因素如牙菌斑或牙結石等，牙齦異常出血的狀況也可獲得改善。本文將提出牙齦異常出血的病例系列報告及診斷流程指引與治療策略。

關鍵字

牙齦異常出血 ； 出血性疾病 ； 止血

並列摘要

Before treating patients with chief complaint of gingival hemorrhage, a thorough medical history, family history, drug history and any previous hemorrhagic episodes should be taken into consideration. Dentists need to identify whether intraoral local factors are the major causes of gingival hemorrhage. When a hemostasis problem is suspected, laboratory evaluations should be carried out. Consultation with other specialists may be necessary to establish the diagnosis and provide preoperative managements for bleeding control during dental treatments. Despite complicated medical condition, the gingival hemorrhage phenomenon can be resolved or relieved under good oral hygiene and periodontal care. In this article, we present case series of gingival hemorrhage and provide decision making diagram and treatment guidelines for treating gingival hemorrhage.

並列關鍵字

gingival hemorrhage ； bleeding disorders ； hemostasis