阿司匹林对拔牙术后出血影响的meta分析  

Effect of aspirin on the risk of postoperative bleeding complications after tooth extractions:a meta-analysis

作　　者：范伟伟 王彦亮[2] 周稚辉[3] 陈冰 FAN Wei-wei;WANG Yan-liang;ZHOU Zhi-hui;CHEN Bing(Department of Stomatology,Wenzhou Central Hospital,Zhejiang Wenzhou 325000,China)

机构地区：[1]温州市中心医院口腔科,浙江325000 [2]温州医科大学附属口腔医院口腔颌面外科,浙江325000 [3]温州医科大学附属第二医院口腔科,浙江325000

出　　处：《中华老年口腔医学杂志》2020年第5期275-279,共5页Chinese Journal of Geriatric Dentistry

摘　　要：目的:通过系统评价和Meta分析的方法探讨拔牙术前是否停用阿司匹林的必要性和影响。方法:两位评价员按照标准的Meta分析流程,系统检索Pubmed、Web of Science、Cochrane图书馆、中国知网、维普、万方、中国生物医学文献数据库等数据库,检索时间截止至2019年9月15日。对纳入的文献提取数据,并独立进行文献质量评价和系统评价。运用RevMan5.3软件进行Meta分析。结果:本研究共纳入文献7篇,均为随机对照试验,文献质量评价结果B级,偏倚风险不清。Meta分析结果显示试验两组术后出现出血并发症的差异无统计学意义(P>0.05),而不停药组术后出血时间虽然显著延长(P<0.05),但仍在正常出血时间范围内。结论:拔牙术前不停用阿司匹林并未显著增加术后出血风险,尽管会延长出血时间,但仍在正常出血时间范围内。因此我们建议不要在拔牙前停用阿司匹林,但有必要加强术前筛查和术后止血措施。Objective:To evaluate the necessity and influence of stopping aspirin before extraction by the method of systematic review and Meta-analysis.Methods:According to the standard meta-analysis procedure,the two reviewers systematically searched the databases such as Pubmed,Web of Science,Cochrane library,cnki,VIP,wanfang and Chinese biomedical literature database,etc.,and the retrieval time was up to September 15,2019.Two reviewers extracted data and assessed the risk of bias independently with the criteria introduced by Cochrane Collaboration.Meta-analysis was done with Review Manager 5.3.Results:A total of 7 literatures were included in this study,all of which were randomized controlled trials.The literature quality evaluation results were grade B,and the risk of bias was unclear.The outcomes of Meta-analysis showed that continuous aspirin before extraction didn't increase the risk of bleeding complications(P>0.05)but prolonged bleeding time(P<0.05)after surgery while it was still within the normal bleeding time range.Conclusion:The aspirin continuous used before tooth extraction did not significantly increased the risk of postoperative bleeding.Although it prolonged bleeding time,it was still within the normal bleeding time range.So,we recommend not stopping long-term aspirin use before tooth extraction but strengthen preoperative screening and hemostasis methods,if necessary.

关 键 词：阿司匹林 拔牙 出血 META分析 

分 类 号：R782.11[医药卫生—口腔医学]