低纤维蛋白原血症导致拔牙后出血1例报告及文献复习（英文）  

Post-extraction Bleeding Caused by Hypofibrinogenemia:Case Report and Review of Literatures

作　　者：於丽明 陆萌萌 罗远 

机构地区：[1]上海市口腔病防治院口腔外科,上海200031

出　　处：《口腔颌面外科杂志》2017年第1期61-64,共4页Journal of Oral and Maxillofacial Surgery

基　　金：supported by the grant of Young Scholars Project of Shanghai Municipal Health Bureau(20154Y0200)

摘　　要：纤维蛋白原是一种在凝血过程中起重要作用的凝血因子。本文报道1例十分罕见的因低纤维蛋白原血症导致的拔牙后出血病例。1名29岁男性患者因拔除左上智齿后出血2 d而来我院就诊,该患者诉平素体健,否认患有系统性疾病,包括血液以及肝脏相关疾病。予局麻下清创处理,3%H2O2冲洗牙槽窝+明胶海绵处理,获得良好的止血效果。1周以后的验血报告显示其血纤维蛋白原水平低(1.6 g/L)。虽然临床上血纤维蛋白原异常的病患很罕见,但是口腔科医生仍需了解低血纤维蛋白原可能会导致术后出血风险的增加。本病例报告提示:对于患有轻度血纤维蛋白原降低的拔牙后出血患者,联合运用明胶海绵可能是一种有效的止血方法。本文还就相关文献进行了详细回顾。Fibrinogen is a coagulation factor that plays a critical role during hemostasis. The purpose of the present article is to report an extremely unusual case of post-extraction bleeding as a result of low plasma fibrinogen. A 29-year-old male came to our hospital with a chief complaint of bleeding for 2 days after left upper third molar extraction. He was in good general health and denied any systemic diseases, including bleeding disorders and liver diseases. Hemostasis was successfully achieved by the application of hydrogen peroxide （H2O2） irrigation and gelatin sponges. One week later, the blood test showed a low plasma fibrinogen level（1.6g/L）. Although fibrinogen abnormalities are rare, dentists should be aware that low plasma fibrinogen levels increase risk of postoperative bleeding. This case indicated that the application of H2O2 （3%） combined with gelatin sponge may be effective in facilitating hemostasis for patients suffering mild fibrinogen deficiency. The relative literatures are reviewed.

关 键 词：纤维蛋白原缺乏症 过氧化氢 拔牙后出血 

分 类 号：R782.11[医药卫生—口腔医学]