Bernardoni-Socorro C, Arteaga-Vizcaino M, Villamizar Y, Diez-Ewald M, Vizcaíno-Salazar G, Torres-Guerra E, Quintero J
Facultad de Odontología, Universidad del Zulia, Maracaibo, Venezuela.
Invest Clin. 1998 Jun;39(2):77-83.
The purpose of the present work was to observe local hemostatic function during dental surgery in patients under oral anticoagulant therapy with an INR between 1.7 and 2.5. Thirty seven dental treatments were performed in 15 patients. Group A: nineteen dental treatments (13 scalings, 1 root canal therapy and 5 dental extractions), treated with oral rinse with tranexamic acid (250 mg dissolved in 10 ml of water). Group B: eighteen dental procedures (13 scaling, 1 root canal therapy and 14 dental extractions), in which oral rinse was utilized. Antibiotics were indicated for those patients with root canal therapy or with signs of infection. A cool soft diet was recommended to all patients during the three days following the surgical procedure. Only in five (13.5%) dental extractions (1 from group A and 4 from B) bleeding prolonged was observed, however periodontal disease was also present in those patients hone of them required blood products or withdrawal of the anticoagulant. The results suggest that mouth washing with tranexamic acid prevents excessive oral bleeding in patients treated with oral anticoagulants with an INR between 1.7 and 2.5.
本研究的目的是观察国际标准化比值(INR)在1.7至2.5之间接受口服抗凝治疗的患者在牙科手术期间的局部止血功能。对15例患者进行了37次牙科治疗。A组:19次牙科治疗(13次洗牙、1次根管治疗和5次拔牙),采用氨甲环酸漱口治疗(250毫克溶解于10毫升水中)。B组:18次牙科手术(13次洗牙、1次根管治疗和14次拔牙),其中采用了漱口。对那些进行根管治疗或有感染迹象的患者使用了抗生素。建议所有患者在手术后三天内食用冷软食。仅在5例(13.5%)拔牙病例中(A组1例,B组4例)观察到出血时间延长,然而这些患者也患有牙周疾病,其中无一例需要血液制品或停用抗凝剂。结果表明,氨甲环酸漱口可防止INR在1.7至2.5之间接受口服抗凝治疗的患者口腔过度出血。