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关于为服用直接口服抗凝剂的患者提牙方案的建议:一项临床试验
Elaine Massumi Higashi1, Itamara Lucia Itagiba Neves1, Francisco Carlos da Costa Darrieux2
1Department of Dentistry of the Heart Institute of Clinics Hospital of the University of São Paulo, São Paulo, SP, Brazil.
Oral surgery, oral medicine, oral pathology and oral radiology
|December 24, 2025
概括
直接口服抗凝剂 (DOACs) 可以安全地用于牙提取,而无需停止使用. 这项研究发现,与华法林相比,出血率没有显著差异,这表明临床实践中的可行性.
科学领域:
- 牙科 牙科是指牙科的专业.
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 抗凝治疗对于心房的患者至关重要.
- 传统上,由于出血风险,在牙科手术前停止使用华法林.
- 直接口服抗凝剂 (DOAC) 提供了一个替代方案,但在牙提取过程中需要对其进行评估.
研究的目的:
- 评估一项协议的可行性,包括在拔牙之前不停止DOACs.
- 为了比较在服用DOAC与华法林时接受牙拔牙的患者的出血率.
主要方法:
- 一项前性,盲目的研究包括58名接受牙拔牙的抗凝血药患者.
- 患者被分为三组:里瓦罗克萨班,达比加特兰/阿皮克萨班和华法林 (对照组).
- 提取的时间与抗凝血剂的最低血度或华法林的治疗INR一致.
主要成果:
- 里瓦洛克萨班组中没有观察到轻微或重大出血.
- 轻微出血发生在达比加特兰/阿皮克萨班组的11.1%,华法林组的10%.
- 两组之间没有发现出血率的统计学上显著差异 (P = .324),没有报告重大出血事件.
结论:
- 初步发现表明,在拔牙过程中继续DOAC是可行的.
- 这一协议可能会简化抗凝药患者的牙科管理.
- 进一步的研究可以在更大的患者队伍中验证这些发现.
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