Deppe Herbert, Mücke Thomas, Auer-Bahrs Julia, Wagenpfeil Stefan, Kesting Marco, Sculean Anton
Department of Oral and Maxillofacial Surgery, Technische Universität München, Germany.
Quintessence Int. 2013 Jul;44(7):513-20. doi: 10.3290/j.qi.a29508.
Thermal Nd:YAG laser energy is well known for the purpose of blood coagulation. However, little is known about the bleeding frequency following laser-assisted oral surgery in patients on coumarin drugs. Therefore, the purpose of this study was to compare retrospectively the frequency of bleeding complications following Nd:YAG laserassisted versus conventional local coagulation of blood in oral surgery.
In October 2002, minor oral surgical interventions were found to be indicated in a total of 45 cardiac risk patients. In Group 1, blood coagulation was yielded in 24 patients with a Nd:YAG laser system, whereas in Group 2, treatment was performed in 21 patients with conventional means of local hemostasis. All therapies were performed continuing anticoagulant therapy between November 2002 and March 2003. Clinical data were recorded retrospectively from patient charts in May 2007.
In both Groups 1 and 2, a total of two bleeding complications were recorded. However, local re-interventions were sufficient for local hemostasis.
These results indicate that Nd:YAG laser-assisted local hemostasis was not able to prevent bleeding complications completely. Within the limitations of this retrospective study it was concluded that in patients with anticoagulant treatment undergoing minor oral surgery, Nd:YAG laser-assisted local hemostasis is not superior to conventional methods of blood coagulation with respect to the frequency of bleeding complications.
钕钇铝石榴石(Nd:YAG)激光能量用于血液凝固已广为人知。然而,对于服用香豆素类药物的患者在激光辅助口腔手术后的出血频率知之甚少。因此,本研究的目的是回顾性比较Nd:YAG激光辅助与传统局部血液凝固在口腔手术中出血并发症的频率。
2002年10月,共45例有心脏风险的患者被发现需要进行小型口腔外科手术。第1组,24例患者使用Nd:YAG激光系统进行血液凝固,而第2组,21例患者采用传统局部止血方法进行治疗。所有治疗均在2002年11月至2003年3月期间继续抗凝治疗。2007年5月从患者病历中回顾性记录临床数据。
第1组和第2组均记录到总共2例出血并发症。然而,局部再次干预足以实现局部止血。
这些结果表明,Nd:YAG激光辅助局部止血不能完全预防出血并发症。在这项回顾性研究的局限性范围内,得出的结论是,对于接受小型口腔手术的抗凝治疗患者,Nd:YAG激光辅助局部止血在出血并发症频率方面并不优于传统的血液凝固方法。