[Haemophilia and dental procedures; a complex combination].

G Mulders, J T van der Tas, M J H A Kruip, F S Kroon, A J G Jansen
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Abstract

A 28-year-old patient with severe haemophilia A presented to the emergency department with significant and painful swelling of the left cheek, an extensive haematoma extending from the left ear to the anterior thoracic region, an intraoral haematoma over the soft palate with deviation of the uvula to the right, and complaints of shortness of breath when lying down. Three days prior, his dentist had performed a restoration of the 36 molar under local anaesthesia. Due to pain, the general practitioner had administered an intramuscular injection of a non-steroidal anti-inflammatory drug (NSAID) two days post-procedure. The patient was admitted for treatment with coagulation factors and pain management. Dental procedures and local anaesthesia in patients with a severe coagulation disorder require specific preparatory measures, such as administration of coagulation factors. Collaboration and consultation with a patient's haematologist or haemophilia treatment centre are essential requirements for safe dental care.

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[血友病与牙科手术;复杂的组合]。
一名 28 岁的重度血友病 A 患者因左脸颊明显肿胀且疼痛难忍、大面积血肿从左耳延伸至胸腔前部、软腭上有口腔内血肿且悬雍垂向右偏移而到急诊科就诊,并主诉躺下时呼吸急促。三天前,他的牙医在局部麻醉下为他修复了 36 颗臼齿。由于疼痛,全科医生在术后两天为其肌肉注射了非甾体抗炎药(NSAID)。患者入院后接受了凝血因子治疗和疼痛治疗。对患有严重凝血障碍的患者进行牙科手术和局部麻醉需要采取特殊的准备措施,如使用凝血因子。与患者的血液科医生或血友病治疗中心合作和协商是安全牙科护理的基本要求。
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