综合护理模式下血友病患者牙科治疗程序的结果：来自三级护理中心的病例分析

Outcomes of Dental Treatment Procedures in People With Haemophilia Treated Under a Comprehensive Care Model: An Analysis of Cases From a Tertiary Care Centre.

作者信息

Kumar Mathangi, Badagabettu Sulochana, Pai Keerthilatha M, Kurien Annamma, Mv Archana, Mayya Shreemathi S, Govindan Sreejith

机构信息

Department of Oral Medicine & Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Department of Fundamentals of Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Haemophilia. 2025 Jul;31(4):617-624. doi: 10.1111/hae.70055. Epub 2025 May 5.

DOI:10.1111/hae.70055

PMID:40322997

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12306850/

Abstract

BACKGROUND

Haemophilia is a chronic, lifelong bleeding disorder that requires interdisciplinary care to manage and mitigate the disease burden throughout a patient's life. There is no universally accepted protocol for managing haemophilia patients during dental care.

OBJECTIVE

To evaluate the state of practice employed for people with haemophilia undergoing various dental treatment procedures under a comprehensive care model in a tertiary care setting.

METHODS

Patient records from the archives of Haemophilia Society of Kasturba Hospital, Manipal were retrieved, and the demographic data, disease status and dental treatment records of each patient were systematically reviewed. The various dental procedures and the outcomes were correlated with the severity of haemophilia and the quantity of prophylactic factors concentrate utilised for the dental treatment procedures.

RESULTS

A total of 73 patients attended the comprehensive Haemophilia clinic during the study period. Sixty nine of them underwent 84 dental treatment procedures. The various dental procedures that were performed on these patients were oral prophylaxis (scaling), extraction of grossly decayed teeth, restoration (fillings) of carious teeth, endodontic treatment and other minor oral surgical procedures. The amount of clotting factor concentrates given prior to dental treatment ranged from 250 to 1500 IU. None of the patients had excessive haemorrhage following dental procedures. Statistical analyses were performed with SPSS software, and statistical significance was set at p < 0.05. Chi-square and Fisher's exact test were used for the analysis of quantitative variables.

CONCLUSION

Standardisation of prophylactic clotting factors for various dental treatment procedures is essential to prevent haemorrhagic complications.

TRIAL REGISTRATION

Clinical Trials Registry - India (CTRI) number: REF/2024/01/077096.

摘要

背景

血友病是一种慢性、终身性出血性疾病，需要跨学科护理来管理和减轻患者一生中的疾病负担。在牙科护理期间，尚无普遍接受的血友病患者管理方案。

目的

评估在三级医疗环境中，采用综合护理模式对接受各种牙科治疗程序的血友病患者所采用的实践状况。

方法

检索了马尼帕尔卡斯图尔巴医院血友病协会档案中的患者记录，并系统回顾了每位患者的人口统计学数据、疾病状况和牙科治疗记录。将各种牙科程序及结果与血友病严重程度以及牙科治疗程序中使用的预防性凝血因子浓缩物数量相关联。

结果

在研究期间，共有73名患者前往血友病综合诊所就诊。其中69名患者接受了84次牙科治疗程序。对这些患者进行的各种牙科程序包括口腔预防（洗牙）、拔除严重龋坏牙齿、修复（补牙）龋齿、牙髓治疗以及其他小型口腔外科手术。牙科治疗前给予的凝血因子浓缩物量在250至1500国际单位之间。牙科手术后，没有患者出现大出血情况。使用SPSS软件进行统计分析，设定统计学显著性为p < 0.05。采用卡方检验和费舍尔精确检验分析定量变量。