Before surgery 1. Carefully ask the patient’s medical history, especially whether the patient has had bleeding and whether the bleeding symptoms have worsened in the past 1 week, and perform routine blood and coagulation function tests, and make a treatment plan according to the patient’s condition. 2. Usually patients with hematologic diseases have poor physical tolerance, so if more affected teeth are extracted, it is better to extract them in stages. 3. Prophylactic use of antibacterial drugs, especially for patients with severe anemia, requires preoperative intravenous use of antibacterial drugs. 4. The concentration of epinephrine in local anesthetic should not exceed 1:100,000. 5. Avoid block anesthesia and submucosal infiltration anesthesia as much as possible, and recommend the use of painless anesthesia instrument for periodontal membrane injection anesthesia, and choose a fine needle and reduce the number of needle entries to prevent blood leakage from the needle eye. Intraoperatively 1. Monitor the patient’s heart rate, blood pressure and oxygen saturation throughout the procedure. 2. Strict aseptic operation is necessary to prevent postoperative infection after tooth extraction. (1) Adopt minimally invasive methods to extract the affected teeth, especially for complex teeth and obstructed teeth, and divide more teeth and remove less bone by special surgical cutting handpieces; (2) Ensure four-handed operation, i.e., the assistant uses a metal suction device to aspirate the patient’s intraoral secretions such as saliva, blood and extracted affected teeth, roots and tooth fragments in a timely manner, so as to achieve both cleanliness of the operative area and exposure of the operative field. (3) Protect the soft and hard tissues in the mouth by using buccal hooks to avoid accidental injury; (4) Use occlusal pads to help the patient open the mouth, which can reduce the discomfort and fatigue of the temporomandibular joint of the patient, but also reveal the surgical field more fully and reduce the risk of accidental injury to the soft and hard tissues of the mouth by surgical instruments. 4.Patients with severe anemia are prone to hypoxia during surgery, so they can undergo tooth extraction under the conditions of high concentration and low flow oxygen absorption during surgery. 5. Closely observe the patient’s facial expression and reaction, and if abnormalities are found, remove the surgical instruments in time. 6. Treatment of tooth extraction wound: Different treatment methods are adopted according to the severity of the patient’s condition. For patients with mild bleeding tendency, absorbable gelatin sponge, thrombin, collagen plug and other hemostatic materials should be filled in the extraction socket to help form a stable blood clot, among which collagen plug has the best hemostatic effect; for patients with moderate bleeding tendency, in addition to filling the extraction socket with hemostatic materials, the wound surface should be protected by periodontal plugging agent, fibrin glue or intraoral band-aid; for patients with severe bleeding tendency, in addition to filling the extraction socket with hemostatic materials, the wound surface should be protected by periodontal plugging agent, fibrin glue or intraoral band-aid. For patients with severe bleeding tendency, in addition to filling the extraction socket with hemostatic material and protecting the wound surface, immediate denture, individualized occlusal plate or retainer should be used to stop the bleeding with pressure. However, suturing the wound is not recommended to avoid bleeding at the eye of the needle. Ligature hemostasis or electrocoagulation can be considered for clear soft tissue bleeding points, and systemic medication is generally not required. Postoperatively 1. Stay in the hospital for observation for 1 h. Patients should be allowed to leave only after it is determined that there is no obvious bleeding, and they should be informed to follow up promptly if there is any abnormality. 2.Rinse the mouth with oral cleanser and enhance oral hygiene. 3.Continue to use antibacterial drugs for 3-5 d to prevent infection. 4.Avoid touching the wound to avoid dislodging the hemostatic filling material, and restrain the hands of pediatric patients to avoid touching the wound. 5. Inform the patient of the doctor’s contact information and leave the patient’s contact information for timely follow-up.