Department of Oral Surgery and Pathology, Faculty of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
Department of Community and Preventive Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
J Craniomaxillofac Surg. 2019 May;47(5):798-804. doi: 10.1016/j.jcms.2019.01.049. Epub 2019 Feb 7.
Some prospective studies have been designed specifically to investigate perioperative bleeding in dental surgery. The quantitative assessment of intraoperative blood loss can be useful for indicating the real risk of bleeding complications, especially in medically compromised individuals. The aim of this study was to evaluate the pattern of bleeding in individuals under vitamin K antagonist (VKA) therapy and non-anticoagulated individuals submitted to dental extractions. Perioperative bleeding was evaluated by using a total collected bleeding corrected by absorbance reading (dental bleeding score). 138 procedures were performed. When the perioperative dental bleeding score was correlated with the number of extracted teeth, the quantity of bleeding was found to be directly proportional to the procedure. Extractions of two or more teeth presented higher scores than single extractions (p = 0.003). In a comparative analysis between the VKA and non-anticoagulated groups, no significant difference in the scores was found. The previous history of complications in dental procedures (p = 0.001) and the use of additional hemostatic measures were higher in the VKA group (p = 0.017). VKA therapy did not impact significantly the volume of blood lost during dental extractions. Perioperative bleeding assessment might be a useful parameter for evaluating patients under antithrombotic treatment.
一些前瞻性研究专门设计来调查牙科手术中的围手术期出血。术中失血量的定量评估对于提示出血并发症的真实风险非常有用，尤其是在有医学合并症的个体中。本研究旨在评估接受维生素 K 拮抗剂（VKA）治疗和未抗凝个体接受拔牙术的个体的出血模式。通过使用通过吸光度读数校正的总收集出血（牙科出血评分）来评估围手术期出血。共进行了 138 次手术。当将围手术期牙科出血评分与拔出的牙齿数量相关联时，发现出血量与手术成正比。两颗或更多牙齿的拔出比单个牙齿的拔出具有更高的评分（p=0.003）。在 VKA 组和未抗凝组之间的比较分析中，评分无显着差异。牙科手术中并发症的既往史（p=0.001）和使用额外的止血措施在 VKA 组中更高（p=0.017）。VKA 治疗并未显著影响拔牙过程中失血量。围手术期出血评估可能是评估抗血栓治疗患者的有用参数。
