Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Public Dental Services, Stockholm, Sweden.
Support Care Cancer. 2024 Oct 7;32(10):703. doi: 10.1007/s00520-024-08917-1.
Benefits of prophylactic platelet (PLT) transfusion before dentoalveolar surgery are unclear. This study investigated the effect of prophylactic PLT transfusions on the incidence of postoperative bleeding (POB) in patients with thrombocytopenia and a PLT count ≤ 75*10/L.
The cohort in this retrospective study comprised 83 patients with thrombocytopenia ≤ 75*10/L who had undergone dentoalveolar surgery. Exclusion criteria were other coagulation deficiencies or medications that would affect hemostasis. In all, 144 teeth had been removed. POB events were extracted and compared between the group that had received prophylactic PLT transfusion before dentoalveolar surgery and the group that had not.
POB events were observed in 5 of 83 patients (6.0%) who had a median PLT count of 3510/L before any transfusion. The group with no postoperative bleeding (NPOB) had a median PLT count of 3410/L. Two (4.2%) of the 48 patients who had received prophylactic PLT transfusions before dentoalveolar surgery developed POB. Three (8.6%) of the 35 patients who had not received a transfusion experienced POB. The difference between these two groups was not significant (p = 0.646). When two or more teeth were removed in the same session, a significantly higher incidence of POB was observed (p = 0.042).
Our data indicate that prophylactic PLT transfusions in thrombocytopenic patients with PLT counts ≤ 75*10/L do not reduce the incidence of POB after dentoalveolar surgery. However, caution is warranted when extracting multiple teeth in the same surgical session since we found this to be significantly associated with an increased risk of POB.
预防性血小板 (PLT) 输注在前牙和牙槽外科手术前的益处尚不清楚。本研究旨在探讨预防性 PLT 输注对血小板计数 ≤ 75*10/L 的血小板减少症患者术后出血 (POB) 发生率的影响。
本回顾性研究纳入了 83 例血小板计数 ≤ 75*10/L 的血小板减少症患者，这些患者均接受了前牙和牙槽外科手术。排除标准为存在其他凝血功能障碍或影响止血的药物。共拔除 144 颗牙齿。比较接受和未接受预防性 PLT 输注的患者的 POB 事件。
5 例患者（6.0%）在接受任何输血前血小板计数中位数为 3510/L 时发生了 POB 事件。未发生 POB（NPOB）的患者血小板计数中位数为 3410/L。2 例（4.2%）接受预防性 PLT 输注的患者在接受前牙和牙槽外科手术前发生了 POB。3 例（8.6%）未接受输血的患者发生了 POB。两组之间差异无统计学意义（p = 0.646）。在同一时间段内拔除两颗或两颗以上牙齿时，POB 的发生率明显更高（p = 0.042）。
我们的数据表明，在血小板计数 ≤ 75*10/L 的血小板减少症患者中，预防性 PLT 输注并不能降低前牙和牙槽外科手术后 POB 的发生率。然而，当在同一手术中拔除多颗牙齿时应谨慎，因为我们发现这与 POB 的风险增加显著相关。
