上海口腔医学 ›› 2020, Vol. 29 ›› Issue (6): 638-641.doi: 10.19439/j.sjos.2020.06.015

• 论著 • 上一篇    下一篇

以口腔表征为首发的血液系统疾病500例临床分析

窦红菊1, 朱虹2   

  1. 1.上海交通大学医学院附属第九人民医院 血液科,上海 200011;
    2.上海交通大学医学院附属第九人民医院·临床医学院,上海 200125
  • 收稿日期:2019-08-08 修回日期:2019-10-25 出版日期:2020-12-25 发布日期:2021-01-08
  • 通讯作者: 朱虹,E-mail:zhuhong1096@126.com
  • 作者简介:窦红菊(1969-),女,硕士研究生,副主任医师,E-mail:douhongju_2005@126.com

Clinical analysis of 500 cases of hematological diseases with oral presentation as the first manifestation

DOU Hong-ju1, ZHU Hong2   

  1. 1. Department of Hematology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    2. Clinical Medical College, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200125, China
  • Received:2019-08-08 Revised:2019-10-25 Online:2020-12-25 Published:2021-01-08

摘要: 目的: 探讨以口腔表征为首发症状的血液系统疾病的临床特点,为早期诊断,防止漏诊误诊提供依据。方法: 回顾近5年因口腔症状首诊于上海交通大学医学院附属第九人民医院口腔相关科室(口腔黏膜病科、牙周病科、牙体牙髓病科和口腔颌面-头颈肿瘤科)的500例血液系统疾病患者的临床资料,分析其口腔表征的多样性及分布情况。结果: 500例首诊于口腔各科的血液系统疾病患者的口腔表征有口腔黏膜和牙龈出血、牙龈增生、口腔黏膜溃疡、口腔黏膜感染及口腔颌面部肿块。其中以口腔颌面部肿块症状首诊者数量居首,占19.8%。血常规、凝血机制和口腔病理活检对血液系统疾病的初步筛查与确诊至关重要。结论: 多种血液系统疾病都可能在疾病初期就出现口腔表征,正确认识血液系统疾病多样性的口腔表征,结合血常规和凝血机制检查以初步筛选血液系统疾病;对表现为口腔颌面部肿块的患者进行肿块活检,可在临床上更早地对血液系统疾病进行诊断和鉴别诊断,从而避免误诊和漏诊。口腔表征的治疗以针对血液系统疾病为主,口腔局部对症治疗为辅。

关键词: 口腔表征, 血液系统疾病, 鉴别诊断

Abstract: PURPOSE: To explore the clinical characteristics of hematological diseases with oral presentation as the first manifestation, and to provide basis for early diagnosis of hematological diseases and prevention of missed diagnosis and misdiagnosis. METHODS: The clinical data of 500 patients with hematological diseases who were first diagnosed in department of stomatology in our hospital during the past five years were reviewed, and the diversity and distribution of oral manifestations of patients with hematological diseases were analyzed. RESULTS: Oral manifestations of 500 patients with hematological diseases were mainly oral mucosa and gingival bleeding, gingival hyperplasia, oral mucosal ulcer, oral mucosal infection, oral and maxillofacial mass. Among them, the number of hematological diseases patients first diagnosed in the department of stomatology with the symptoms of oral and maxillofacial mass was the largest, accounting for 19.8%. Blood routine, coagulation mechanism and oral pathological biopsy were very important for preliminary screening and diagnosis of hematological diseases. CONCLUSIONS: Oral manifestations of various hematological diseases may occur at the early stage of the disease. Correct understanding of oral manifestations of the diversity of hematological diseases, combined with blood routine and coagulation mechanism examination, can preliminarily screen hematological diseases. Pathological examination of tumors in patients with oral and maxillofacial masses can be carried out. Diagnosis and differential diagnosis of hematological diseases can be made earlier in clinic, so as to avoid misdiagnosis and missed diagnosis. For patients with hematological diseases first diagnosed in the department of stomatology, the treatment of oral characterization mainly focuses on hematological diseases, supplemented by local symptomatic treatment of oral cavity.

Key words: Oral presentation, Hematological disease, Differential diagnosis

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