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重组治疗时代血友病患者的牙科管理:疗效提高且临床风险降低。

Dental management of patients with haemophilia in the era of recombinant treatments: increased efficacy and decreased clinical risk.

作者信息

Liras Antonio, Romeu Luis

机构信息

Universidad Complutense de Madrid, Madrid, Spain.

出版信息

BMJ Case Rep. 2019 Apr 8;12(4):e227974. doi: 10.1136/bcr-2018-227974.

Abstract

Haemophilia is a hereditary X-linked recessive disorder caused by a deficiency of either clotting factor VIII (haemophilia A) or IX (haemophilia B). Conventional treatment is currently based on the use of either plasma derived or recombinant coagulation factors. This paper reports on the case of a patient with severe haemophilia who presented with mesial decay and interproximal tartar build-up, for which extraction and scaling to remove tartar deposits were indicated. Following extraction, the usual haemostasis techniques were applied, and postoperative prophylactic antihaemophilic treatment was indicated for 2 or 3 days. The patient presented with moderate bleeding for a few minutes immediately after the procedure. Administration of factor VIII before surgery as well as the patient's favourable pharmacokinetic response allowed for an optimal result. This treatment has afforded patients with haemophilia a better quality of life, and safe and efficient access to invasive surgical procedures.

摘要

血友病是一种遗传性X连锁隐性疾病,由凝血因子VIII(A型血友病)或IX(B型血友病)缺乏引起。目前传统治疗方法是使用血浆源性或重组凝血因子。本文报告了一名患有严重血友病的患者,该患者出现了近中龋坏和邻面牙石堆积,为此需要拔牙并进行洗牙以清除牙石沉积物。拔牙后,采用了常规止血技术,并建议进行2至3天的术后预防性抗血友病治疗。术后几分钟患者出现了中度出血。术前给予VIII因子以及患者良好的药代动力学反应带来了最佳效果。这种治疗为血友病患者提供了更好的生活质量,以及安全有效的侵入性手术途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c28e/6453434/5652f565a195/bcr-2018-227974f01.jpg

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