Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, USA.
Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Sep;128(3):243-249. doi: 10.1016/j.oooo.2019.04.005. Epub 2019 Apr 16.
To examine postoperative bleeding in patients taking antiplatelet and anticoagulant medications after invasive periodontal procedures.
This 6-year retrospective study collected data from the electronic health records of patients who underwent invasive periodontal procedures at the College of Dentistry, University of Kentucky Lexington, from January 1, 2011 through April 1, 2017. Records were included when the medical history was current, an invasive periodontal procedure was performed, an antiplatelet or anticoagulant medication was taken, and a postoperative visit was documented.
Four hundred and fifty-six patients (age range 22-89 years; mean age 66.1 years; 58% male) met the inclusion criteria and underwent 867 invasive periodontal procedures. Antiplatelet medications, warfarin, a direct oral anticoagulant, or a combination of these drugs were taken during 484 scaling and root planing procedures, 218 implant placements, 53 open flap debridements, 16 gingival grafts, 15 lateral windows, and 71 other. Medications were continued in 99.6% of patients during the procedure. Postoperative bleeding occurred after three procedures (0.35%) and resolved with local hemostatic measures. Medications were temporarily discontinued in four instances (range 1-5 days); none of these patients experienced postoperative bleeding.
Postoperative bleeding was infrequent in patients who underwent an invasive periodontal procedure while taking an antiplatelet or anticoagulant drug.
研究接受侵入性牙周治疗的患者在服用抗血小板和抗凝药物后的术后出血情况。
本研究为回顾性研究,共纳入 2011 年 1 月 1 日至 2017 年 4 月 1 日期间在肯塔基大学列克星敦分校牙科学院接受侵入性牙周治疗的患者。纳入标准为:患者病历资料完整、接受侵入性牙周治疗、正在服用抗血小板或抗凝药物、并记录术后随访情况。
共 456 例患者(年龄 22-89 岁,平均年龄 66.1 岁,男性占 58%)符合纳入标准,共进行了 867 次侵入性牙周治疗。在 484 次龈下刮治和根面平整术、218 次种植体植入术、53 次翻开瓣清创术、16 次牙龈移植术、15 次侧向骨切开术和 71 次其他治疗中,患者正在服用抗血小板药物、华法林、直接口服抗凝剂或上述药物联合治疗。在 99.6%的患者中,治疗期间药物持续使用。有 3 例(0.35%)出现术后出血,通过局部止血措施得以解决。有 4 例(1-5 天)患者暂时停用药物,均未发生术后出血。
在接受侵入性牙周治疗的患者中,服用抗血小板或抗凝药物后发生术后出血的情况较为少见。