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接受抗血栓药物治疗的患者拔牙后出血的危险因素——一项病例对照研究。

Risk factors for bleeding after dental extractions in patients receiving antithrombotic drugs - A case control study.

作者信息

Huang Jinxia, Liu Jie, Shi Haitao, Wu Jun, Liu Jiyuan, Pan Jian

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Sichuan, China.

The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.

出版信息

J Dent Sci. 2022 Apr;17(2):780-786. doi: 10.1016/j.jds.2021.10.005. Epub 2021 Oct 20.

Abstract

BACKGROUND/PURPOSE: Patients receiving antithrombotic drugs are more likely to suffer bleeding after tooth extraction and multiple factors are related to it. The aim of this study was to investigate the incidence of bleeding and risk factors for bleeding after dental extractions in patients receiving antithrombotic drugs.

MATERIALS AND METHODS

This retrospective case control study included patients receiving oral antithrombotic drugs or not. Tooth extractions were conducted under ECG monitoring and local hemostatic measures were performed. Risk factors for postoperative hemorrhage after tooth extraction were evaluated using univariate and multivariate analyses.

RESULTS

Bleeding events were reported in 27 (27%) patients receiving antithrombotic drugs and 9 (9%) patients who didn't use antithrombotic drugs, the difference between which was significant ( < 0.01). Univariate analyses showed that age (OR = 2.717,  = 0.028), oral hygiene (OR = 4.110,  = 0.043), inferior nerve block (OR = 4.285, p = 0.038) and number of extracted tooth (OR = 4.758, p = 0.029) were significantly correlate with bleeding incidence. Multivariate analysis revealed that age (OR = 2.824, p = 0.036) and number of extracted tooth (OR = 5.268, p = 0.016) were significant risk factors for postextraction bleeding.

CONCLUSION

The results suggest that there is higher incidence of postextraction bleeding in patients receiving antithrombotic drugs compared to patients who don't. Age (>75 years), oral hygiene, inferior nerve block and number of extracted tooth may be related to bleeding after tooth extraction.

摘要

背景/目的:接受抗血栓药物治疗的患者拔牙后更易出血,且有多种因素与之相关。本研究旨在调查接受抗血栓药物治疗的患者拔牙后出血的发生率及出血危险因素。

材料与方法

本回顾性病例对照研究纳入了接受或未接受口服抗血栓药物治疗的患者。拔牙在心电图监测下进行,并采取局部止血措施。采用单因素和多因素分析评估拔牙后术后出血的危险因素。

结果

27例(27%)接受抗血栓药物治疗的患者和9例(9%)未使用抗血栓药物的患者报告了出血事件,两者差异有统计学意义(<0.01)。单因素分析显示,年龄(OR = 2.717,= 0.028)、口腔卫生状况(OR = 4.110,= 0.043)、下牙槽神经阻滞(OR = 4.285,p = 0.038)和拔牙数量(OR = 4.758,p = 0.029)与出血发生率显著相关。多因素分析显示,年龄(OR = 2.824,p = 0.036)和拔牙数量(OR = 5.268,p = 0.016)是拔牙后出血的显著危险因素。

结论

结果表明,与未接受抗血栓药物治疗的患者相比,接受抗血栓药物治疗的患者拔牙后出血发生率更高。年龄(>75岁)、口腔卫生状况、下牙槽神经阻滞和拔牙数量可能与拔牙后出血有关。

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