Suppr超能文献

口腔外科急诊中的继发性出血:一项横断面研究。

Secondary Bleedings in Oral Surgery Emergency Service: A Cross-Sectional Study.

作者信息

Igelbrink Sebastian, Burghardt Stefan, Michel Barbara, Kübler Norbert R, Holtmann Henrik

机构信息

Clinic for Oral and Maxillofacial Surgery, University of Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.

Clinic for Oral and Maxillofacial Surgery, University Clinic of Duesseldorf, Moorenstr 5, 40225 Duesseldorf, Germany.

出版信息

Int J Dent. 2018 Jun 3;2018:6595406. doi: 10.1155/2018/6595406. eCollection 2018.

Abstract

INTRODUCTION

Bleeding after dental surgery is still a common cause for emergency presentation in patients using anticoagulants. Our aim was to analyze pertinent characteristic features on the one hand and to bare existing problems in handling on the other.

MATERIALS AND METHODS

The study included 76 patients. We documented basic data, anticoagulant medication, type of surgery, and tooth socket sutures in respective patients.

RESULTS

The vast majority of patients took a coumarin derivative (41) and acetylsalicylic acid (27). Nine (12%) of the patients had to be hospitalized due to ongoing bleeding despite local haemostyptic steps and/or circulatory dysregulation. Most patients could be successfully treated in outpatient settings. No statistically significant correlation between bleeding, level of INR value, number of extracted teeth, and sewed alveoli could be shown. Sixty-five percent of cases with tooth extractions did not have suture of tooth sockets. Eighty-seven percent of the patients denied being informed about possible self-treatment options by their surgeon/dentist, and none of the patients got presurgical-fabricated bandage plate(s).

CONCLUSIONS

Patients taking coumarin derivative currently, furthermore, represent the biggest anticoagulant after-bleeding group in dentoalveolar surgery. The major part of after-bleedings (90%) can be handled in an outpatient setting with simplest surgical interventions. Unfortunately, the biggest part of the patient collective got no suture, no prefabricated dental bandage plate(s), and no explanation by their dentist how to handle in case of after-bleeding. Therefore, dental practitioners should furthermore get enlightenment on how to prevent after-bleeding situations.

摘要

引言

牙科手术后出血仍是使用抗凝剂患者紧急就诊的常见原因。我们的目的一方面是分析相关特征,另一方面是揭示处理中存在的问题。

材料与方法

该研究纳入了76例患者。我们记录了各患者的基本数据、抗凝药物、手术类型和牙槽窝缝合情况。

结果

绝大多数患者服用香豆素衍生物(41例)和乙酰水杨酸(27例)。尽管采取了局部止血措施和/或循环调节措施,仍有9例(12%)患者因持续出血而不得不住院。大多数患者可在门诊成功治疗。出血、国际标准化比值(INR)水平、拔牙数量和缝合牙槽之间未显示出统计学上的显著相关性。65%的拔牙病例未进行牙槽窝缝合。87%的患者否认其外科医生/牙医告知过他们可能的自我治疗选择,且没有患者得到术前制作的绷带板。

结论

目前服用香豆素衍生物的患者是牙槽外科手术后抗凝剂引起出血的最大群体。大部分术后出血(90%)可通过最简单的外科干预在门诊处理。不幸的是,大部分患者群体未进行缝合,未得到预制牙科绷带板,且其牙医未就术后出血的处理方法进行解释。因此,牙科医生应进一步了解如何预防术后出血情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1962/6008757/cae2fc21c5ca/IJD2018-6595406.001.jpg

相似文献

10
Postoperative Bleeding Following Dental Extractions in Patients Anticoagulated With Warfarin.华法林抗凝患者拔牙术后出血
J Oral Maxillofac Surg. 2016 Aug;74(8):1518-23. doi: 10.1016/j.joms.2016.04.007. Epub 2016 Apr 22.

引用本文的文献

本文引用的文献

2
Oral surgery during therapy with anticoagulants-a systematic review.抗凝治疗期间的口腔外科手术——一项系统评价
Clin Oral Investig. 2015 Mar;19(2):171-80. doi: 10.1007/s00784-014-1366-3. Epub 2014 Nov 22.
4
Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants.服用抗凝剂患者牙槽外科手术后的出血风险。
Br J Oral Maxillofac Surg. 2014 Mar;52(3):e15-9. doi: 10.1016/j.bjoms.2014.01.006. Epub 2014 Jan 30.

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验