国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (6): 730-737.doi: 10.7518/gjkq.2025068

• 牙体牙髓病学专栏 • 上一篇    下一篇

牙髓病治疗过程中的出血管理

陈双(),付盛禹,叶玲,汪成林()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2024-06-29 修回日期:2025-04-12 出版日期:2025-11-01 发布日期:2025-10-23
  • 通讯作者: 汪成林
  • 作者简介:陈双，硕士，Email：cs001019@163.com
  • 基金资助:
    四川省自然科学基金面上项目(2024NSFSC0551);四川大学华西口腔医院探索与研发项目(LCYJ2019-18);四川大学华西口腔医院探索与研发项目(LCYJ-2022-YY-2)

Management of bleeding in treatment of endodontics

Shuang Chen(),Shengyu Fu,Ling Ye,Chenglin Wang()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-06-29 Revised:2025-04-12 Online:2025-11-01 Published:2025-10-23
  • Contact: Chenglin Wang
  • Supported by:
    Sichuan Natural Science Foundation Project(2024NSFSC0551);Exploration and Creation Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-18)

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摘要：

牙髓病治疗过程中的出血风险通常较低，其出血管理常被医生所忽视，但出血控制不良对局部治疗的影响不可忽视。出血原因中，全身因素包括凝血功能异常或服用抗凝血药物等，局部因素包括牙龈牙周组织的炎症状态、牙髓及根尖周组织损伤、医源性损伤等。目前常用的止血方法主要是全身药物管理，局部药物止血、压迫止血、化学止血、缝合止血等，如何正确进行出血管理以减少其对牙髓病治疗的影响在临床上需要重视。本文从出血危害、原因及预防和处理的角度对牙髓病非手术和手术治疗过程中各种出血情况的管理作一综述，为牙髓病临床治疗提供参考。

关键词: 牙髓出血, 根尖周出血, 出血危害, 出血原因, 出血管理

Abstract:

The treatment of pulp diseases is generally associated with a low risk of bleeding, and the management of bleeding is often neglected by dentists. However, the impact of poor bleeding control on local treatment cannot be ignored. Bleeding is caused by systemic factors, such as coagulation dysfunction or anticoagulant intake, and local factors, such as inflammatory state of the gingival and periodontal tissues, damage to the pulp and periapical tissues, and iatroge-nic injury. Commonly used methods for hemostasis are systemic drug management, local drug hemostasis, pressure hemostasis, chemical hemostasis, and suturing hemostasis, etc. Proper management of bleeding to reduce its impact on the treatment of pulp diseases needs to be considered in clinical practice. This article provides a review of the management of va-rious bleeding situations during non-surgical and surgical treatments of pulp diseases, from the perspectives of the dangers, causes, prevention, and treatment of bleeding. Results provide a reference for the clinical treatment of pulp diseases.

Key words: pulp bleeding, periapical bleeding, hazards of bleeding, cause of bleeding, management of bleeding

中图分类号: 

  • R781.05
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