口服抗凝药物老年患者拔牙术中的临床治疗体会  

Clinical observation of bleeding after tooth extraction in the elderly with anticoagulant drug

作　　者：王磊[1] 沈敏华[1] 黄伟琴[1] 宋霞萍 赵懿 徐余波 WANG Lei;SHEN Min-hua;HUANG Wei-qin;SONG Xia-ping;ZHAO Yi;XU Yu-bo(Department of Stomatology,East Hospital,Tongji University,Shanghai 200120,China)

机构地区：[1]同济大学附属东方医院口腔科,上海200120

出　　处：《中华老年口腔医学杂志》2020年第1期26-29,共4页Chinese Journal of Geriatric Dentistry

基　　金：上海市浦东新区卫生系统特色专病学科建设基金(PWZzb2017-16)。

摘　　要：目的:总结在服用抗凝药物的老年患者拔牙术中的治疗经验。方法:选择2018年1月~2019年6月口腔科就诊的46例(服用阿司匹林患者28例,波立维11例,法华林7例)长期口服抗凝药物且需要拔牙老年患者,拔牙前行凝血酶原时间和国际标准化率检测,分别在术后30分钟、1和24小时对治疗结果进行观察和分析。结果:拔牙术后30分钟出血15例,术后1小时内出血4例,术后24小时复诊出血1例。结论:INR在1.5~2.5范围,拔牙创局部止血处理,且压迫观察1小时,有效地预防抗凝治疗的老年患者在不停用抗凝药的情况下拔牙术后出血的情况。Objective:To summarize the treatment experience ofthe tooth extraction in elderly patients taking anticoagulant drugs.Methods:From January 2018 to June 2019,46 patients(28 aspirin patients,11 bolivar patients and 7 farwarn patients)who were admitted to the department of stomatology were selected as long-term oral anticoagulants and needed tooth extraction Before teeth extractions,all patients had a prothrombin time(PT)and the international normalized ratio(INR)determined.The results were observed and analyzed at 30 minutes 1 hour and 24 hours after the operation Results:There were 15 patients with bleeding within 30 minutes after tooth extraction,4 patients with bleeding within 1 hour after tooth extraction,and 1 patient with recurrent bleeding within 24 hours after tooth extraction.Conclusion:Tooth extraction with local hemostasis can effectively prevent postoperative hemorrhage in elderly patients treated with anticoagulant therapy without stopping anticoagulants,INR was in the range of 1.5~2.5.

关 键 词：抗凝药 出血 拔牙术 老年人 

分 类 号：R782.11[医药卫生—口腔医学]