口服阿司匹林慢性牙周炎伴妇科疾病患者的临床治疗研究  

Clinical study on patients with chronic periodontitis and gynecological diseases treated with oral aspirin

作　　者：沈光养 马湘一 陈美玲 吴冷 朱光勋[2] SHEN Guang-yang;MA Xiang-yi;CHEN Mei-ling;WU Leng;ZHU Guang-xun(Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China;Department of Stomatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院口腔医学中心,湖北武汉430030

出　　处：《临床口腔医学杂志》2022年第6期360-363,共4页Journal of Clinical Stomatology

基　　金：国家自然科学基金项目(81300883);湖北省自然科学基金(2019CFB688、2021CFB056);武汉市创新人才开发资金(2014);同济医院回国人员启动基金(2016)。

摘　　要：目的:评估慢性牙周炎伴妇科疾病患者在长期口服小剂量阿司匹林治疗的同时给与牙周基础治疗的出血风险,探讨同时治疗的可行性。方法:选取长期口服小剂量阿司匹林的慢性牙周炎伴妇科疾病患者90例,按照术前是否停用阿司匹林治疗,分为服药组45例,停药组45例。统计分析两组患者基本信息及牙周相关指标。术后观察牙周局部出血情况。结果:服药组与停药组的菌斑指数、探诊深度、附着丧失比较差异无显著意义,而服药组的出血指数明显高于停药组(P<0.05)。研究对象采用花生四烯酸法(arachidonic acid,AA)检测两组患者血小板最大聚集率(maximum platelet aggregation rate,MPAR),停药组MPAR为(68.5±2.1)%,服药组为(12.6±1.5)%,两组间差异有统计学意义(P<0.05)。两组病例均顺利进行了牙周基础治疗,术后30 min服药组有3例,停药组有1例牙龈活动性渗血,采取局部止血措施后彻底止血。结论:长期口服小剂量阿司匹林的慢性牙周炎合并妇科疾病患者在实施牙周基础治疗前无需停用阿司匹林,局部治疗安全且有效。Objective:To evaluate the bleeding risk of patients with chronic periodontitis and gynecological diseases treated with long-term oral low-dose aspirin and initial periodontal therapy,and to explore the feasibility of simultaneous treatment.Methods:Ninety cases with gynecological diseases and chronic periodontitis who took low-dose aspirin for a long time were selected and divided into 45 cases in the oral medication group and 45 cases in the withdrawal group according to whether aspirin treatment was stopped before operation.The basic information and periodontal related indexes of the two groups were statistically analyzed.Local periodontal bleeding was observed after operation.Results:There was no significant difference in plaque index,probing depth and attachment loss between the treatment group and the withdrawal group,while the bleeding index of the treatment group was significantly higher than that of the withdrawal group(P<0.05).The maximum platelet aggregation rate(MPAR)of the two groups was detected by arachidonic acid(AA)method.The MPAR of the withdrawal group was(68.5±2.1)%,and the treatment group was(12.6±1.5)%,the difference was statistically significant(P<0.05).Both groups of patients underwent initial periodontal treatment safely.There were 3 cases in the treatment group 30 minutes after the operation,and 1 case in the withdrawal group had active gingival bleeding.After partial hemostatic measures were taken,the bleeding was completely stopped.Conclusion:Local treatment of patients with chronic periodontitis and gynecological diseases who have long-term oral low-dose aspirin is safe and effective and do not need to stop aspirin before initial periodontal treatment.

关 键 词：阿司匹林 慢性牙周炎 妇科疾病 止血 

分 类 号：R781.4[医药卫生—口腔医学] R711[医药卫生—临床医学]