出血性疾病病患的牙科治療

Dental Management for Patient with Bleeding Disorders

許嘉淩(Chia-Ling Hsu) ； 陳亮如(Lian-Ru Chen) ； 劉正芬(Jeng-Fen Liu)

《臺灣兒童牙醫學雜誌》 10卷2期 (2010/08) Pp. 47-58

https://doi.org/10.6319/TJPD.2010.10(2).1

摘要

具出血性疾病的病患接受侵入性的牙科治療後，可能會發生術後出血時間延長的危險。不僅是病患本身，就連牙醫師也對這類病患接受牙科治療感到憂心，而這樣的擔心常會影響醫師的治療意願。所幸，過去病史和理學檢查可用來評估病患接受牙科治療後是否會延長術後出血時間。具出血性疾病的病患接受牙科治療前，可先會診其內科醫師，詳細評估與訂定適當的治療計畫後才開始治療。本文章主在了解正常凝血機制及出血性疾病，牙科治療前的預防處理，以及治療中及治療後出血的處理。

關鍵字

止血 ； 凝血異常 ； 牙科治療 ； 抗凝血劑 ； 血友病

並列摘要

Many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to congenital and acquired coagulopathy. Dentists often worried about delivering treatment to this special group. The medical history and laboratory tests are critical for identification of patients potentially at risk for prolonged bleeding from dental treatment. The vast majority of patients with suspected coagulopathies are best managed in the community practice setting. Dental treatment of patients with bleeding disorders is best accomplished by dentists who are knowledgeable about the pathology, complications and treatment options associated with these conditions. This article describes normal coagulation mechanism, bleeding abnormalities, preoperative systemic precautions and intraoperative hemostatic management.

並列關鍵字

Hemostasis ； dental treatment ； coagulapathy ； anticoagulant ； antiplatelet agents