中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (3): 226-229.doi: 10.19438/j.cjoms.2021.03.008

• 论著 • 上一篇    下一篇

术前继续口服抗凝药对复杂牙拔除术后出血的影响

郝新河, 高超, 沈末伦, 叶虎, 赵君, 储德强, 翟沁凯   

  1. 合肥市口腔医院,安徽医科大学合肥口腔临床学院 口腔颌面外科,安徽 合肥 230001
  • 收稿日期:2021-01-08 修回日期:2021-02-20 发布日期:2021-07-16
  • 通讯作者: 翟沁凯,E-mail: zhaiqinkai@163.com
  • 作者简介:郝新河（1966-）,男,学士,副主任医师,E-mail: haoxinhe1966@163.com
  • 基金资助:
    安徽省重点研究与开发计划项目（201904a07020023）; 合肥市卫计委应用医学研究项目（hwk2018zc009）; 合肥市自主创新政策“借转补”资金项目（J2019Y03）

Effect of continuous oral anticoagulant therapy on the risk of postoperative bleeding events in patients undergoing extraction of complication teeth

HAO Xin-he, GAO Chao, SHEN Mo-lun, YE Hu, ZHAO Jun, CHU De-qiang, ZHAI Qin-kai   

  1. Department of Oral and Maxillofacial Surgery, Hefei Stomatology Hospital. Hefei 230001, Anhui Province, China
  • Received:2021-01-08 Revised:2021-02-20 Published:2021-07-16

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摘要： 目的 探讨术前不停用抗凝药对复杂牙拔除术后出血的影响。方法 前瞻性队列研究分析2020年7月—2020年9月在合肥市口腔医院外科门诊行复杂牙拔除术[翻瓣和（或）去骨],术前继续口服抗凝药物的51例患者。按口服抗凝药物的种类分为华法林组和阿司匹林组,比较2组术后30 min、1 h、24 h术区出血情况。采用SPSS 17.0软件包对数据进行统计学分析。结果 口服华法林患者26例,阿司匹林25例,均为单颗复杂牙拔除。术后30 min,术区出血患者19例（37.3%）,其中华法林组9例（34.6%）,阿司匹林组10例（40%,P=0.691）。术后1 h,术区出血患者8例（15.7%）,其种华法林组4例（15.4%）,阿司匹林组4例（16%,P=0.952）。术后24 h,延迟出血患者2例（3.9%）,均为口服华法林患者（7.7%,P=0.157）,均为磨牙拔除术后出血（6.5%,P=0.247）。结论 华法林组和阿司匹林组,术后出血率未见显著差异。术前不停用华法林的患者行复杂磨牙拔除术,有延期出血的可能。

关键词: 抗凝药, 复杂牙拔除术, 出血, 华法林, 阿司匹林

Abstract: PURPOSE: To investigate the incidence of bleeding events after surgical tooth extraction in patients without withdrawal of oral anticoagulant therapy. METHODS: This prospective cohort study included 51 patients who were treated with oral anticoagulants undergoing surgical dental extractions from July 2020 through September 2020. Surgical extraction referred to a procedure requiring the elevation of a mucoperiosteal flap and/or an osteotomy. The primary predictor variables were the kinds of anticoagulant drugs, including warfarin and aspirin. The primary outcome measurement was the incidence of bleeding events after surgical dental extraction. Chi-square test was used for statistical analysis with SPSS 17.0 software package. RESULTS: Twenty-six patients taking warfarin showed 9(34.6%) bleeding episodes and 25 patients receiving aspirin presented 10 (40%) bleeding episodes 30 minutes after tooth extractions, with a total of 19(37.3%) bleeding cases(P=0.691). Bleeding complications occurred in 4 patients(15.4%) in the warfarin group and 4 patients(16%) in the aspirin group respectively, at 1 hour after tooth extractions, with a total of 8 (15.7%) bleeding complications(P=0.952). Two patients（3.9%） developed delayed bleeding more than 24 hours after operation, both underwent molar extraction while taking warfarin(P=0.157). CONCLUSIONS: No significant difference was observed between patients with bleeding after surgical extractions. It is more likely to have delayed bleeding more than 24 hours after operation in patients taking warfarin undergoing molar extraction.

Key words: Oral anticoagulant therapy, Tooth extraction, Bleeding, Warfarin, Aspirin

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