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[牙科急诊中口腔出血患者的临床特征及危险因素]

[Clinical features and risk factors of patients with oral bleeding in dental emergency].

作者信息

Guo Huaqiu, Wang Zhe, Yang Xue, Bai Jie

机构信息

Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Feb 18;57(1):142-147. doi: 10.19723/j.issn.1671-167X.2025.01.021.

Abstract

OBJECTIVE

To analyze the clinical characteristics and risk factors of patients with oral bleeding.

METHODS

A retrospective study was performed on patients with oral bleeding in the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2019 to December 2022. The distribution of the patients ' gender, age, cause of bleeding, systemic condition, treatment methods and risk factors of hemostasis methods, and number of visits were analyzed.

RESULTS

A total of 4 764 patients with oral bleeding were enrolled, including 2 660 males (55.84%) and 2 104 females (44.16%), with an average age of 40.7 years. The most common causes of oral bleeding were bleeding after tooth extraction (3 080 cases, 64.65%), followed by gingival bleeding (1 386 cases, 29.09%), bleeding after outpatient surgery (194 cases, 4.07%), maxillofacial mass bleeding (33 cases, 0.69%), postoperative bleeding of inpatient (24 cases, 0.50%), and bleeding from other causes (47 cases, 0.99%). Simple hemostatic methods were applied in 1 867 cases (39.19%) while 2 897 cases (60.81%) used complex methods, among which iodine strip tamponade and suture were the most commonly used methods of hemostasis. Logistic regression analysis showed that the male patients had a higher proportion of complex methods than the female patients; gingival bleeding were often stopped by simple hemostatic methods while complex methods were more likely to be applied in the patients with bleeding after tooth extraction. The patients with hypertension and coagulation disorders were more likely to visit the hospital for repeated bleeding. Gender and age did not affect the number of visits.

CONCLUSION

Oral bleeding was one of the common diseases in oral emergency. The common causes were bleeding after tooth extraction and gingival bleeding. Most patients could be treated by compression, local suture and packing of iodine strips while some cases with severe bleeding needed further treatment to stop bleeding. A minority of patients with oral bleeding could induce systemic complications, which should be paid full attention by clinicians.

摘要

目的

分析口腔出血患者的临床特征及危险因素。

方法

对2019年1月至2022年12月北京大学口腔医学院口腔急诊科口腔出血患者进行回顾性研究。分析患者的性别、年龄、出血原因、全身状况、治疗方法及止血方法的危险因素、就诊次数。

结果

共纳入4764例口腔出血患者,其中男性2660例(55.84%),女性2104例(44.16%),平均年龄40.7岁。口腔出血最常见的原因是拔牙后出血(3080例,64.65%),其次是牙龈出血(1386例,29.09%)、门诊手术后出血(194例,4.07%)、颌面部肿物出血(33例,0.69%)、住院患者术后出血(24例,0.50%)、其他原因出血(47例,0.99%)。1867例(39.19%)采用简单止血方法,2897例(60.81%)采用复杂方法,其中碘条填塞和缝合是最常用的止血方法。Logistic回归分析显示,男性患者采用复杂方法的比例高于女性患者;牙龈出血常采用简单止血方法,而拔牙后出血患者更可能采用复杂方法。高血压和凝血障碍患者更易因反复出血就诊。性别和年龄不影响就诊次数。

结论

口腔出血是口腔急诊常见疾病之一。常见原因是拔牙后出血和牙龈出血。多数患者可通过压迫、局部缝合及碘条填塞治疗,部分严重出血病例需进一步治疗止血。少数口腔出血患者可诱发全身并发症,临床医生应予以充分重视。

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本文引用的文献

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[Analysis of death cases in the oral emergency department].[口腔急诊科死亡病例分析]
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Feb 18;56(1):185-189. doi: 10.19723/j.issn.1671-167X.2024.01.029.
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When do we need more than local compression to control intraoral haemorrhage?何时我们需要采取局部压迫以外的措施来控制口腔内出血?
J Korean Assoc Oral Maxillofac Surg. 2019 Dec;45(6):343-350. doi: 10.5125/jkaoms.2019.45.6.343. Epub 2019 Dec 26.
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A bleeding socket after tooth extraction.拔牙后出血的牙槽窝。
BMJ. 2017 Apr 3;357:j1217. doi: 10.1136/bmj.j1217.
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Systemic Disease and Bleeding Disorders for the Oral and Maxillofacial Surgeon.
Oral Maxillofac Surg Clin North Am. 2016 Nov;28(4):461-471. doi: 10.1016/j.coms.2016.06.004.

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