服用抗凝剂对心脏瓣膜置换术后行拔牙术的临床观察  

Tooth extraction in patients with anticoagulant therapy after heart valve replacement:A clinical observation

作　　者：胡莹莹 张建华[1] 薛昌敖[1] 吴新[1] 张瑞[1] HU Yingying;ZHANG Jianhua;XUE Changao;WU Xin;ZHANG Rui(Department of Stomatology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)口腔科,南京210000

出　　处：《口腔颌面外科杂志》2023年第6期394-396,共3页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨心脏瓣膜置换术后服用抗凝剂的患者,行拔牙术的围手术期用药及安全性。方法:对南京市第一医院口腔科于2019年1月至2021年12月心脏瓣膜置换术后需拔除磨牙的患者采用病例对照研究。研究组(n=66例)为心脏瓣膜置换术后服用华法林行抗凝治疗的患者;对照组(n=150例)为未使用抗凝药物使用者。2组患者在进行围手术期用药及止血处理后,比较其拔牙后出血及创口愈合情况。结果:2组患者术后出血率、术后7 d拔牙创愈合情况比较,差异无统计学意义(P>0.05)。结论:对服用抗凝剂后需要拔牙的患者采用低分子肝素替代治疗,既能保证围手术期的安全,又可预防因停药导致的并发症。Objective:To investigate the application and security of anticoagulants during the perioperative period of tooth extraction in patients after heart valve replacement.Methods:A case-control study was carried out on patients with molar teeth extraction from the Department of Stomatology,Nanjing First Hospital from January 2019 to December 2021.The patients in the research group(n=66)took warfarin anticoagulation after heart valve replacement;the control group consisted of 150 patients didn't take anticoagulant.Perioperative medication and hemostasis were performed to compare bleeding and wound healing after tooth extraction.Results:There was no significant difference between the two groups in the bleeding rate after operation and the healing of tooth extraction wounds 7 days after operation(P>0.05).Conclusion:The replacement therapy with low molecular weight heparin can not only ensure the safety of the perioperative period,but also prevent the complications caused by withdrawal of the drug.

关 键 词：心脏瓣膜置换 华法林 抗凝治疗 拔牙术 

分 类 号：R782[医药卫生—口腔医学]