直接口服抗凝剂在简单和手术拔牙期间和之后的持续使用:一项前性临床队列研究
Krister Johansson1,2, Jonas P Becktor3, Aron Naimi-Akbar3,4
1Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden. krister.johansson@mau.se.
BMC oral health
|April 12, 2025
概括
在拔牙过程中继续服用直接口服抗凝剂 (DOAC) 是安全的,并且与华法林相比,可能会降低出血风险. 这种方法避免了与暂停抗凝药治疗相关的血栓栓塞风险.
科学领域:
- 在口腔外科手术.
- 血栓形成的管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 在口腔手术期间,缺乏标准化指导方针来管理直接口服抗凝剂 (DOAC).
- 潜在的不必要的DOAC停止,增加血栓塞栓症的风险.
- 需要评估在拔牙期间继续DOACs的患者的出血和并发症.
研究的目的:
- 评估在简单和手术牙拔除期间和之后继续DOAC的患者出血和其他并发症的风险.
- 为了比较服用DOACs和接受牙科拔牙的华法林患者之间的结果.
主要方法:
- 160名接受DOAC治疗的患者和56名接受华法林治疗的患者进行前性研究,354名患者接受牙拔除 (2016年5月至2023年12月).
- 使用局部止血剂和松酸进行出血管理.
- 对所有患者进行了为期7天的随访;使用千平方,t测试和回归模型进行统计分析.
主要成果:
- 术后出血发生在27%的DOAC患者和37%的华法林患者中 (p=0.35).
- 在DOAC患者中,需要干预的临床相关出血率较低 (3%对11%,p=0.06).
- 没有需要住院或输血的严重出血;可比的外科手术期间出血量.
结论:
- 患者可以在牙提取期间和之后安全地继续DOAC.
- 与华法林相比,持续服用DOAC可能导致出血风险较低.
- 消除与抗凝药中断相关的血栓栓塞事件的风险.
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