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拔牙后出血的危险因素分析及急救干预策略研究

Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies.

作者信息

Shao Xiao, Xu Xun-Min, Yang Xue, Ji Ai-Ping

机构信息

Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, 100089, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2024 May 16;17:1279-1286. doi: 10.2147/RMHP.S458260. eCollection 2024.

Abstract

OBJECTIVE

The objective of this investigation is to delineate the distributional attributes of factors correlated with post-tooth extraction bleeding and to scrutinize corresponding strategies for emergency prevention and intervention.

METHODS

The chi-squared test and rank sum test were deployed to evaluate fluctuations in blood loss. Univariate and multivariate binary logistic regression methodologies were employed to compute the odds ratio (OR) and its associated 95% confidence interval (95% CI). Furthermore, we delved into the relationship between each contributing factor and blood loss. Concurrently, univariate and multivariate logistic regression techniques were utilized to probe the nexus between blood loss and treatment modalities.

RESULTS

Following adjustments for pertinent factors, the outcomes of multivariate analyses unveiled an escalated susceptibility to bleeding among male patients and individuals aged 60 years or older. The adjusted OR values and their corresponding 95% CI were determined as follows: OR = 1.54 (95% CI: 1.34-1.77, P < 0.001), OR = 0.74 (95% CI: 0.59-0.91, P = 0.005), OR = 0.58 (95% CI: 0.42-0.80, P = 0.001). Additionally, the results of multivariate logistic regression analysis indicated that, in contrast to individuals experiencing minimal blood loss, the OR values associated with treatment modalities for patients encountering substantial blood loss, namely iodoform gauze strips, sutures, collagen, and compression, were noted as follows: OR = 220.80 (95% CI: 151.43-321.95, P < 0.001), OR = 69.40 (95% CI: 46.11-104.44, P < 0.001), OR = 52.78 (95% CI: 34.66-80.38, P < 0.001), OR = 12.85 (95% CI: 9.46-17.45, P < 0.001).

CONCLUSION

It is imperative to prioritize the scrutiny of risk factors associated with post-tooth extraction hemorrhage, with the aim of preemptively averting incidences of bleeding subsequent to tooth extraction. Moreover, it is paramount to offer expert and tailored emergency interventions designed to address diverse case scenarios.

摘要

目的

本研究旨在描绘与拔牙后出血相关因素的分布特征,并审视相应的紧急预防和干预策略。

方法

采用卡方检验和秩和检验评估失血量的波动情况。运用单因素和多因素二元逻辑回归方法计算比值比(OR)及其相关的95%置信区间(95%CI)。此外,我们深入研究了每个促成因素与失血量之间的关系。同时,利用单因素和多因素逻辑回归技术探究失血量与治疗方式之间的联系。

结果

在对相关因素进行调整后,多因素分析结果显示男性患者和60岁及以上个体出血易感性增加。调整后的OR值及其相应的95%CI如下:OR = 1.54(95%CI:1.34 - 1.77,P < 0.001),OR = 0.74(95%CI:0.59 - 0.91,P = 0.005),OR = 0.58(95%CI:0.42 - 0.80,P = 0.001)。此外,多因素逻辑回归分析结果表明,与失血量极少的个体相比,失血量较大的患者采用的治疗方式(即碘仿纱条、缝合、胶原蛋白和压迫)的OR值如下:OR = 220.80(95%CI:151.43 - 321.95,P < 0.001),OR = 69.40(95%CI:46.11 - 104.44,P < 0.001),OR = 52.78(95%CI:34.66 - 80.38,P < 0.001),OR = 12.85(95%CI:9.46 - 17.45,P < 0.001)。

结论

必须优先审查与拔牙后出血相关的危险因素,以预防拔牙后出血事件的发生。此外,提供专业且量身定制的紧急干预措施以应对不同病例情况至关重要。

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