綜合三種不同抗凝血以及抗血小板藥物作用導致牙齦自發性出血－病例報告

Spontaneous Gingiva Bleeding Caused by the Combined Use of Three Different Anticoagulant and Antiplatelet Drugs-A Case Report

陳佳政(Chia-Cheng Chen) ； 方家恩(Chia-En Fang) ； 邱昱瑋(Yu-Wei Chiu) ； 呂邁(Mai Lu)

《中華民國家庭牙醫學雜誌》 9卷2期 (2014/09) Pp. 42-48

https://doi.org/10.6566/JFD/2014.9(2).42

摘要

凝血功能異常在一般家庭牙科或是口腔外科的手術治療中，都需要特別注意。由於醫學的進步，人類的壽命也隨之延長，伴隨而來的則是心血管疾病的高度盛行，尤其是在年長的病人當中，這些患者經常服用一種以上的抗凝血藥物，來預防再次的心血管意外。本病例是一位94歲的老先生，由於心血管方面的疾病而同時服用Bokey®、Orfarin®，後來因內科醫師調整藥物，以Pradaxa®替換Orfarin®，但由於藥物半衰期重疊的關係，導致凝血時間極度的延長造成牙齦自發性的流血不止，同時血紅素也異常低下。經停止使用所有的抗凝血藥物以及住院輸血治療之後，凝血功能與血紅素逐漸恢復正常，出院回內科醫師門診接受後續追蹤治療。

關鍵字

普栓達 ； 凝血功能異常 ； 抗凝血藥物

並列摘要

Bleeding disorder is an important issue in both dental treatment and surgical procedures. With the advance of medicine, men's life expectancy was lengthened considerably. However, the chances of elder people who suffered from cardiovascular disease are also increased manifestly. These patients usually took multiple anticoagulant or antiplatelet drugs in order to avoid cardiovascular accident again. The patient is a 94-years-old man who took both Bokey® and Orfarin® because of old cardiovascular disease. The physician adjusted his medicine and Pradaxa® was substituted for Orfarin®. His coagulation time was extremely prolonged and bleeding from gingival sulcus spontaneously because the half-life of medicine was overlapped. His laboratory data also showed that hemoglobin was unusually low. After stopped all of the anticoagulation or antiplatelet drugs and blood transfusion during hospitalization, his coagulation function and hemoglobin were returned to normal limitation. He discharged and keeps follow-up routinely at OPD.

並列關鍵字

Dabigatran ； bleeding disorder ； anticoagulant drugs