Halfpenny W, Fraser J S, Adlam D M
Addenbrookes Hospital, Cambridge, United Kingdom.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Sep;92(3):257-9. doi: 10.1067/moe.2001.115463.
The objective of this study was to compare the use of a resorbable oxycellulose dressing with a fibrin adhesive for the prevention of postextraction hemorrhage in patients taking anticoagulants.
A control group of 26 patients with a preoperative international normalized ratio (INR) in the range of 2.0 to 4.2 had extractions performed with the use of local anesthesia and the socket(s) dressed with a resorbable oxycellulose dressing and sutured with a resorbable suture. The study group with a comparable INR range of 2.1 to 4.1 was treated in a similar manner, except the sockets were dressed with a fibrin adhesive.
No discernible difference in the postoperative outcome with regard to hemorrhage was noted. Postoperative pain was reported more frequently in the group that used a resorbable oxycellulose dressing. Only 1 patient had significant postoperative bleeding.
This study shows that in patients receiving warfarin whose INR is within the therapeutic range, the fibrin adhesive is as effective as the resorbable oxycellulose dressing in preventing postextraction hemorrhage.
本研究的目的是比较可吸收氧化纤维素敷料与纤维蛋白粘合剂在预防服用抗凝剂患者拔牙后出血方面的应用。
26例术前国际标准化比值(INR)在2.0至4.2范围内的患者作为对照组,在局部麻醉下进行拔牙,拔牙窝用可吸收氧化纤维素敷料覆盖并用可吸收缝线缝合。INR范围在2.1至4.1的可比研究组以类似方式治疗,不同之处在于拔牙窝用纤维蛋白粘合剂覆盖。
在出血的术后结果方面未观察到明显差异。使用可吸收氧化纤维素敷料的组术后疼痛报告更频繁。只有1例患者术后有明显出血。
本研究表明,对于接受华法林治疗且INR在治疗范围内的患者,纤维蛋白粘合剂在预防拔牙后出血方面与可吸收氧化纤维素敷料一样有效。