Davis Clayton, Robertson Chad, Shivakumar Sudeep, Lee Min
Department of Oral and Maxillofacial Surgery, Capital Health & Dalhousie University, QEII Health Science Centre, VG site, Halifax, Nova Scotia, Canada.
J Can Dent Assoc. 2013;79:d74.
Direct thrombin inhibitors, specifically orally administered dabigatran etexilate, are emerging as alternatives to warfarin for anticoagulation in the management of atrial fibrillation and venous thromboembolism. The risk associated with bleeding events while taking dabigatran has been documented in multiple randomized controlled trials, but to date, no studies have focused on the risk of bleeding after dental extraction. Extraction of teeth is one of the most common surgical procedures and may cause significant bleeding, so a thorough understanding of the pharmacology of anticoagulant medications is required to prevent complications. With the increasing use of direct thrombin inhibitors, the safe management of patients taking these anticoagulants must be delineated. This review compares dabigatran and warfarin, especially in terms of their effects on dental and oral surgery practice, and examines best management of these patients in light of the existing literature.
直接凝血酶抑制剂，特别是口服的达比加群酯，正逐渐成为华法林在心房颤动和静脉血栓栓塞管理中抗凝治疗的替代药物。服用达比加群时出血事件相关风险已在多项随机对照试验中得到记录，但迄今为止，尚无研究聚焦于拔牙后出血风险。拔牙是最常见的外科手术之一，可能导致大量出血，因此需要全面了解抗凝药物的药理学知识以预防并发症。随着直接凝血酶抑制剂的使用日益增加，必须明确服用这些抗凝剂患者的安全管理方法。本综述比较了达比加群和华法林，尤其在它们对牙科和口腔外科实践的影响方面，并根据现有文献探讨了这些患者的最佳管理方法。
