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本文引用的文献

1
Lack of evidence for increased postoperative bleeding risk for dental osteotomy with continued aspirin therapy.继续使用阿司匹林治疗时，牙截骨术术后出血风险增加缺乏证据。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jan;119(1):17-9. doi: 10.1016/j.oooo.2014.08.016. Epub 2014 Sep 16.
2
Lack of evidence for increased risk of postoperative bleeding after cutaneous surgery in the head and neck in patients taking aspirin.没有证据表明服用阿司匹林的患者在头颈部进行皮肤手术后出血风险会增加。
Br J Oral Maxillofac Surg. 2014 Jul;52(6):527-9. doi: 10.1016/j.bjoms.2014.02.020. Epub 2014 Apr 2.
3
Assessment of the risk of haemorrhage and its control following minor oral surgical procedures in patients on anti-platelet therapy: a prospective study.抗血小板治疗患者口腔小手术出血风险及其控制的评估：一项前瞻性研究。
Int J Oral Maxillofac Surg. 2014 Jan;43(1):99-106. doi: 10.1016/j.ijom.2013.08.014. Epub 2013 Sep 25.
4
Review of postoperative bleeding risk in dental patients on antiplatelet therapy.抗血小板治疗的牙科患者术后出血风险的综述。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Apr;115(4):491-9. doi: 10.1016/j.oooo.2012.11.001. Epub 2013 Jan 16.
5
Should antiplatelet and anticoagulant medications be discontinued before minor oral surgery procedures?在进行小型口腔外科手术前，抗血小板和抗凝药物是否应该停用？
J Can Dent Assoc. 2012;78:c24.
6
Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.抗栓治疗的围手术期管理：抗栓治疗与血栓预防，第 9 版：美国胸科医师学会循证临床实践指南。
Chest. 2012 Feb;141(2 Suppl):e326S-e350S. doi: 10.1378/chest.11-2298.
7
Safety of dental extractions in coronary drug-eluting stenting patients without stopping multiple antiplatelet agents.经皮冠状动脉介入治疗（PCI）术后双联抗血小板治疗期间行拔牙术的安全性。
Clin Cardiol. 2012 Apr;35(4):225-30. doi: 10.1002/clc.21960. Epub 2012 Jan 25.
8
Bleeding incidence after oral surgery with continued oral anticoagulation.持续口服抗凝治疗情况下口腔手术后的出血发生率。
Clin Oral Investig. 2012 Oct;16(5):1371-6. doi: 10.1007/s00784-011-0649-1. Epub 2011 Dec 13.
9
Prevalence, predictors, and long-term prognosis of premature discontinuation of oral antiplatelet therapy after drug eluting stent implantation.药物洗脱支架置入术后抗血小板治疗过早停药的发生率、预测因素及长期预后。
Am J Cardiol. 2011 Jan 15;107(2):186-94. doi: 10.1016/j.amjcard.2010.08.067.
10
Current thoughts on treatment of patients receiving anticoagulation therapy.目前关于接受抗凝治疗患者的治疗思路。
J Oral Maxillofac Surg. 2010 Nov;68(11):2879-87. doi: 10.1016/j.joms.2010.04.007. Epub 2010 Aug 19.

在继续使用氯吡格雷抗血小板治疗的情况下进行口腔手术的术后出血风险。

Postoperative bleeding risk for oral surgery under continued clopidogrel antiplatelet therapy.

作者信息

Gröbe Alexander, Fraederich Meike, Smeets Ralf, Heiland Max, Kluwe Lan, Zeuch Jürgen, Haase Martina, Wikner Johannes, Hanken Henning, Semmusch Jan, Al-Dam Ahmed, Eichhorn Wolfgang

机构信息

Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.

Department of Oral and Maxillofacial Surgery, General Hospital Balingen, Tuebinger Straße 30, 72336 Balingen, Germany.

出版信息

Biomed Res Int. 2015;2015:823651. doi: 10.1155/2015/823651. Epub 2015 Jan 6.

DOI:10.1155/2015/823651
PMID:25632402
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4303007/
Abstract

OBJECT

To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin. Design. Retrospective single center observatory study of two study groups and a control group.

METHODS

A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.

RESULTS

We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0-1.7%, 0-4.7%, and 0-7.8%, respectively, and the incidences did not differ significantly among the three groups (P > 0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.

CONCLUSIONS

Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.

摘要

目的

确定在继续使用氯吡格雷进行单药抗血小板治疗以及氯吡格雷/阿司匹林联合治疗的情况下进行口腔截骨术的术后出血发生率。设计。对两个研究组和一个对照组进行回顾性单中心观察性研究。

方法

分别对在继续使用氯吡格雷单药治疗和氯吡格雷/阿司匹林联合治疗下进行的64例和60例口腔截骨术进行了为期两周的术后出血随访。另外281例类似手术作为对照组也进行了随访。所有口腔截骨术均在门诊进行。

结果

我们观察到对照组281例中有2例（0.7%）发生术后出血，氯吡格雷组64例中有1例（1.6%），氯吡格雷/阿司匹林联合组60例中有2例（3.3%）。相应的95%置信区间分别为0 - 1.7%、0 - 4.7%和0 - 7.8%，三组之间的发生率无显著差异（P > 0.09）。所有病例的术后出血均通过局部措施成功治疗。无需改变抗血小板药物、输血或住院治疗。未记录到重大心血管事件。

结论

我们的结果表明，在继续使用氯吡格雷进行单药抗血小板治疗或氯吡格雷/阿司匹林联合抗血小板治疗的情况下，可以安全地进行小型口腔手术。