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Haemophilia:患有出血性疾病的儿童和青少年的牙齿习惯和口腔健康评估

2021-11-27 MedSci原创 MedSci原创

口腔健康是血友病治疗中心 (HTC) 护理的重要组成部分。口腔健康与炎症之间的相关性表明,适当的口腔健康可以改善关节健康。

遗传性出血性疾病,如血管性血友病(VWD)、血友病和罕见的因子缺陷,影响着美国的许多儿童和青少年。口腔健康是血友病治疗中心 (HTC) 护理的重要组成部分。口腔健康与炎症之间的相关性表明,适当的口腔健康可以改善关节健康。



评估患有出血性疾病的儿科患者的牙科习惯、需求和口腔健康状况,并确定口腔健康不良的预测因素。国外一杂志刊登了一项研究,从2016年5月至2017年10月,连续的儿童HTC患者完成了14个问题的调查,并由牙科专业人员进行检查。描述性分析、卡方检验和逻辑回归模型确定了与四种主要牙科结果相关的特征。

表1:龋齿风险评估:由主要护理者报告的按百分比和n值进行的龋齿风险评估的结果

表2:龋齿风险评估的临床检查:由牙医或牙科保健师报告的按百分比和n值计算的第三类龋齿风险评估的结果

表3:与先天性出血障碍患者的四种不同牙科结局相关的特征

结果提示包括来自 226 名连续患者(1-20 岁)的评估。诊断包括血友病 A 和 B (64%)、血管性血友病 (25%) 和其他出血性疾病 (13%)。近一半的患者报告说每天不刷牙两次(44%)。四分之一的患者目前没有牙医 (27%),15% 的患者报告了获得牙科护理的具体挑战。口腔筛查显示出明显的病理变化:89% 的患者有菌斑堆积,37% 有牙龈炎,8% 有提示龋齿的病变。多变量分析显示,主要照顾者有活跃的蛀牙与可疑病变(OR 4.34,CI 1.41-13.35)和牙龈红斑(OR 3.44,CI 1.63-7.25)的发生率显着增加以及每天刷牙两次的比率较低有关(或 .17,CI .08-.37)。

综上所述,患有出血性疾病的儿童通常有明显的牙齿病变,并报告牙齿护理存在障碍,构成潜在的发病风险。主要看护人的牙齿健康与儿童的牙齿病理密切相关。

原始出处:

Brown, MCHastie, EShumake, CWaters, BSidonio, RFDental habits and oral health in children and adolescents with bleeding disorders: A single-institution cross-sectional studyHaemophilia202117https://doi.org/10.1111/hae.14457

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    2022-03-18 changfy
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    2021-11-29 zhouqu_8
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    2021-11-27 12182b71m12暂无昵称

    学习

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出血性疾病是急诊常见病,每年约15%~20%的患者因各种原因导致的出血而就诊于急诊科,包括急性创伤性出血、非常创伤性出血和手术及侵入性操作导致的出血。临床处理主要包括手术、介入治疗、直接压迫以及药物止血。常用的止血药物主要包括: ①作用于血管及血管壁类药物,如垂体后叶素、卡络磺钠等; ②作用于血小板类药物,如酚磺乙胺;③促进凝血系统功能类药物,如新鲜冰冻血浆(FFP)/人凝血酶

拓展阅读

罕见病例!凝血因子XIII缺乏所致的出血性疾病

对于特殊或罕见的出血异常,临床与检验的沟通至关重要,另一方面,检验医师应加强自身建设,做好检验与临床知识的整合,为临床合理选择检验项目提供有价值的建议。

杨欣教授:出血性疾病所致异常子宫出血,有哪些核心诊治点?

出血性疾病所致的异常子宫出血是一类病因很复杂、可以导致严重大出血并危及生病的难治性异常子宫出血。在治疗原发疾病的同时,应合理地管理AUB,控制月经过多,改善患者的生存质量。

Blood:GGCX的不同突变对维生素K依赖蛋白的生物学功能的影响不同

γ-谷氨酰羧化酶(GGCX)是一种完整的膜蛋白,催化多种维生素K依赖性(VKD)蛋白的翻译后羧化,参与多种生理过程,包括凝血、血管钙化和骨代谢。自然发生的GGCX突变与多种不同的临床表型相

基于中医“痰瘀理论”,龙华医院王拥军、梁倩倩研究团队首先提出淋巴系统是治疗出血性疾病的潜在靶点

首先提出淋巴系统是治疗出血性疾病的潜在靶点,揭示硬脑膜淋巴系统在清除蛛网膜下腔出血的红细胞过程发挥重要作用。

《血凝酶在出血性疾病中应用的专家共识》(2018)要点

出血性疾病是急诊常见病,每年约15%~20%的患者因各种原因导致的出血而就诊于急诊科,包括急性创伤性出血、非常创伤性出血和手术及侵入性操作导致的出血。临床处理主要包括手术、介入治疗、直接压迫以及药物止血。常用的止血药物主要包括: ①作用于血管及血管壁类药物,如垂体后叶素、卡络磺钠等; ②作用于血小板类药物,如酚磺乙胺;③促进凝血系统功能类药物,如新鲜冰冻血浆(FFP)/人凝血酶

出血性疾病治疗应用血液制剂的专家共识

出血性疾病(以下简称出血病)在临床实践中非常常见,应用正确的诊疗措施,对患者的救治非常关键。本分会结合上海的临床用血实际情况,在广泛征求临床一线专家意见的基础上,初步达成本共识。现推荐给与输血相关机构参考或采行。

给住院医师的临床指南要点:评估疑似虐待儿童的出血性疾病

美国儿科学会(AAP,American Academy of Pediatrics) · 2023-02-07

早产儿凝血功能与临床出血性疾病关系的研究进展

重庆医科大学附属儿童医院重症医学科 · 2022-12-10

出血性疾病所致异常子宫出血诊治专家共识

北京大学人民医院 · 2022-11-15

出血性疾病治疗应用血液制剂的专家共识

上海市医学会(ShangHai Medical Association) · 2017-07-30

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