抗栓治疗患者不停药拔牙的临床观察  

Clinical observation of extractionin of teeth in patients with antithrombotic therapy

作　　者：李京荣[1] 邢玉静[2] 曾文军[3] LI Jing-rong;XING Yu-jing;ZENG Wen-jun(Department of Stomatology,Beijing Puren Hospital,Beijing 100062,China)

机构地区：[1]北京市普仁医院口腔科,北京100062 [2]北京市普仁医院老年科,北京100062 [3]北京市普仁医院心血管内科,北京100062

出　　处：《北京口腔医学》2023年第6期424-427,共4页Beijing Journal of Stomatology

摘　　要：目的观察长期抗栓治疗患者不停药拔牙出血、愈合情况,评价拔牙后局部止血效果。方法选取该院MDT拔牙门诊抗栓治疗不停药拔牙患者74例,分为抗血小板治疗组(37例)和抗凝血治疗组(37例),随机选择50例未经抗栓治疗拔牙者为对照组,均拔除单颗牙,观察术后不同时间段出血情况以及术后7 d创口愈合情况。结果3组均未出现不可控制出血。抗血小板治疗组和对照组出血率差异无统计学意义(P>0.05)。抗凝血治疗组和对照组拔牙后30 min出血率差异有统计学意义(P<0.001),抗凝血治疗组高于对照组。拔牙后7 d三组间愈合率有统计学差异(P=0.034),对照组愈合率高于抗凝血治疗组。抗血小板治疗组和对照组间的愈合率不存在差异(P>0.05)。结论抗栓患者做好术前风险评估、术中规范操作和术后密切监测,在不停药情况下可以拔牙,局部止血可达到目的。Objective To observe the bleeding and healing of tooth extraction in patients with antithrombotic therapy,and to evaluate the effect of local hemostasis after tooth extraction.Methods A total of 74 patients were randomly divided into antiplatelet group(37 cases)and anticoagulant group(37 cases),and 50 patients without antithrombotic treatment served as control.The bleeding at different time points and wound healing 7 days after surgery were observed.Results There was no uncontrollable bleeding in the three groups.There was no significant difference in bleeding rate between the antiplatelet group and the control group(P>0.05).There was significant difference in bleeding rate 30min after tooth extraction between the anticoagulant group and the control group(P<0.001),and the anticoagulant group was higher than the control group.There was a significant difference in the healing rate among the three groups 7 days after tooth extraction(P=0.034),and the healing rate of the control group was higher than that of the anticoagulation treatment group.There was no difference in the healing rate between the antiplatelet treatment group and the control group(P>0.05).Conclusions For antithrombotic patients,tooth extraction can be performed without stopping the drug under the condition of preoperative risk assessment,standardized operation and close monitoring after operation.

关 键 词：抗栓治疗 拔牙 出血 

分 类 号：R782.11[医药卫生—口腔医学]