António Natália, Castro Graça, Ramos Domingos, Machado António, Gonçalves Lino, Macedo Tice, Providência Luís A
Serviço de Cardiologia, Hospitals da Universidade de Coimbra, Coimbra, Portugal.
Rev Port Cardiol. 2008 Apr;27(4):531-44.
The management of patients taking long-term oral anticoagulants who require dental surgery is still highly controversial. The risk of bleeding associated with dental treatment under oral anticoagulants must be weighed against the risk of thromboembolism associated with suspension of antithrombotic therapy. Mortality and morbidity associated with thromboembolic events are higher than those associated with hemorrhagic events after minor oral surgery procedures. Evidence-based information does not support oral anticoagulant suspension before minor oral surgery. The authors propose a management protocol for chronically anticoagulated patients who require a dental procedure, to reduce both thromboembolic risk and the risk of bleeding.
对于需要进行牙科手术的长期口服抗凝剂治疗患者，其管理仍存在很大争议。口服抗凝剂治疗下牙科治疗相关的出血风险必须与抗血栓治疗中断相关的血栓栓塞风险相权衡。在小型口腔外科手术后，血栓栓塞事件相关的死亡率和发病率高于出血事件相关的死亡率和发病率。循证信息不支持在小型口腔外科手术前停用口服抗凝剂。作者提出了一种针对需要进行牙科手术的长期抗凝患者的管理方案，以降低血栓栓塞风险和出血风险。
