Sudheesh K M, Bharani K S N Siva, Kiran H Y, Hanagavadi Suresh
Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, Karnataka, India.
Department of Pathology, J J M Medical College, Davangere, Karnataka, India.
Indian J Dent. 2016 Sep;7(3):149-152. doi: 10.4103/0975-962X.186700.
Dental extraction in hemophiliacs with acquired inhibitors is always a risky procedure, which often presents a lot of problems associated with bleeding. A known case of hemophilia A complicated with factor VIII inhibitors and having odontogenic infection was successfully managed by transfusion of factor VIII inhibitor bypass activity (FEIBA) and antihemophilic factor. Past medical history was significant for multiple factor VIII transfusions. Bethesda assay done to identify inhibitors revealed low titer factor VIII inhibitors. Extraction of the involved tooth was done after transfusion of FEIBA with low-dose protocols. Minimal bleeding was noted after extraction which was controlled by local measures. FEIBA was proven to be highly effective, and no side effects of the product were observed.
患有获得性抑制剂的血友病患者进行拔牙始终是一项有风险的操作,常常会出现许多与出血相关的问题。一名已知的甲型血友病合并因子VIII抑制剂且患有牙源性感染的病例,通过输注因子VIII抑制剂旁路活性制剂(FEIBA)和抗血友病因子成功得到治疗。既往病史显示有多次输注因子VIII的情况。为确定抑制剂而进行的贝塞斯达检测显示因子VIII抑制剂滴度较低。在按照低剂量方案输注FEIBA后拔除了患牙。拔牙后出血极少,通过局部措施得以控制。事实证明FEIBA非常有效,且未观察到该产品的副作用。