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纤维蛋白原是一种在凝血过程中起重要作用的凝血因子。本文报道1例十分罕见的因低纤维蛋白原血症导致的拔牙后出血病例。1名29岁男性患者因拔除左上智齿后出血2 d而来我院就诊,该患者诉平素体健,否认患有系统性疾病,包括血液以及肝脏相关疾病。予局麻下清创处理,3%H2O2冲洗牙槽窝+明胶海绵处理,获得良好的止血效果。1周以后的验血报告显示其血纤维蛋白原水平低(1.6 g/L)。虽然临床上血纤维蛋白原异常的病患很罕见,但是口腔科医生仍需了解低血纤维蛋白原可能会导致术后出血风险的增加。本病例报告提示:对于患有轻度血纤维蛋白原降低的拔牙后出血患者,联合运用明胶海绵可能是一种有效的止血方法。本文还就相关文献进行了详细回顾。
Fibrinogen is a coagulation factor that plays an important role in the clotting process. This article reports a very rare case of bleeding due to hypofibrinogenemia after tooth extraction. A 29-year-old male patient came to our hospital for bleeding for 2 days after removal of the upper left wisdom teeth. The patient complained of physical health and denied having systemic diseases including blood and liver-related diseases. To local anesthesia debridement treatment, 3% H2O2 rinse gum groove + gelatin sponge, get good hemostatic effect. Blood tests after 1 week showed low levels of fibrinogen (1.6 g / L). Although patients with clinically abnormal fibrinogen are rare, dentists still need to understand that low fibrinogen may lead to an increased risk of postoperative bleeding. This case report suggests that gelatin sponge may be an effective hemostatic method for patients with post-extraction hemorrhage who have reduced fibrinogen. This article also carried out a detailed review of the relevant literature.