Blinder D, Martinowitz U, Ardekian L, Peleg M, Taicher S
Dept. of Oral and Maxillofacial Surgery, Chaim Sheba Medical Center, Tel Hashomer.
Harefuah. 1996 May 15;130(10):681-3, 727.
Minor oral surgery, in patients being treated with anticoagulant therapy, constitutes a problem for the oral and maxillofacial surgeon. 77 patients getting coumarin underwent 168 oral surgical procedures (tooth extraction, apicoectomy, crown-lengthening, excision of lesions) without lowering the dose of anticoagulant. Local hemostasis was achieved in all cases by silk suture. For tooth extraction gelfoam was used as well. In 12 patients who presented with postoperative bleeding, it was controlled in all by gauze pressure with tranexamic acid and/or biologic glue and/or surgical splinting. Postoperative bleeding was not correlated with the international normalized ratio (INR), but with degree of local inflammation. The study shows that interruption of anticoagulant therapy in such cases is not justified, and the use of tranexamic acid or biological glue can control bleeding.
对于正在接受抗凝治疗的患者而言，小型口腔外科手术给口腔颌面外科医生带来了一个难题。77名接受香豆素治疗的患者在未降低抗凝剂剂量的情况下接受了168例口腔外科手术（拔牙、根尖切除术、牙冠延长术、病变切除术）。所有病例均通过丝线缝合实现局部止血。拔牙时也使用了明胶海绵。12例出现术后出血的患者，均通过使用氨甲环酸和/或生物胶和/或外科夹板进行纱布压迫来控制出血。术后出血与国际标准化比值（INR）无关，而是与局部炎症程度有关。该研究表明，在此类病例中中断抗凝治疗是不合理的，使用氨甲环酸或生物胶可以控制出血。
