多种抗凝药物联用致牙龈持续出血的临床处置1例报告并文献复习  

Clinical management of persistent gingival bleeding induced by the combination of multiple anticoagulant drugs:A case report and literature review

作　　者：金雷 薛超 王世美 蔡伟鑫 JIN Lei;XUE Chao;WANG Shimei;CAI Weixin(Department of Stomatology,the People's Hospital of Fengqing County,Lincang 675900;Department of Oral and Maxillofacial Surgery,Hospital of Stomatology,Sun Yat-sen University,Guangzhou 510055,China)

机构地区：[1]凤庆县人民医院口腔科,临沧675900 [2]中山大学附属口腔医院口腔颌面外科,广州510055

出　　处：《口腔颌面外科杂志》2025年第2期160-162,共3页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:回顾性分析2023年5月云南省凤庆县人民医院收治的1例洗牙后出血不止的病例,探讨由全身因素引起的口腔操作后出血不止的预防和处理方法。方法:入院后,请心血管内科、药剂科、血液内分泌科会诊,局部外用重酒石酸去甲肾上腺素及冰生理盐水,静脉滴注维生素K、氨甲环酸。结果:入院48 h后局部止血,患者生命体征平稳,复查各项指标均无明显异常。结论:口腔有创操作前应详细询问患者的病史,对于长期服用抗凝药的患者,尤其是多药联用者,多学科会诊可有效指导治疗,降低术后出血风险。Objective:To retrospectively analyse a case of uncontrollable bleeding after supragingival scaling that occurred in May 2023 at the People's Hospital of Fengqing County,Yunnan Province.The prevention and management of uncontrollable bleeding caused by systemic factors after invasive oral procedures were discussed.Methods:A multidisciplinary consultation was conducted with the cardiology,pharmacy,and hematology-endocrinology departments.Local treatment included the application of levonordefrin tartrate and cold saline.Intravenous administration of vitamin K and tranexamic acid was also provided.Results:Hemostasis was achieved locally within 48 hours after admission.The patient's vital signs stabilized,and follow-up laboratory examinations showed no significant abnormalities.Conclusion:A thorough inquiry into the patient's medical history is essential before performing invasive oral procedures.For patients on long-term anticoagulant therapy,particularly those using multiple anticoagulants,multidisciplinary consultations can effectively guide treatment and reduce the risk of postoperative bleeding.

关 键 词：多学科诊疗 出血 抗凝药联用 

分 类 号：R782[医药卫生—口腔医学]