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首页> 外文期刊>Folia medica >Discontinuation of Oral Antiplatelet Agents before Dental Extraction - Necessity or Myth?
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Discontinuation of Oral Antiplatelet Agents before Dental Extraction - Necessity or Myth?

机译：拔牙前停用口服抗血小板药-是必要还是神话？

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Background: The risk of excessive bleeding often prompts physicians to interrupt the antiplatelet agents as acetylsalicilyc acid and clopidogrel before dental extractions which puts patients at risk of adverse thrombotic events.Aim: To assess the bleeding risk during dental extractions in patients with continued antiplatelet therapy.Materials and methods: The study included 130 patients (64 men and 66 women) aged between 18 and 99 years old. Sixty-eight of the patients received 100 mg acetilsalicilic acid (ASA); these were divided into two groups: 34 patients continued taking ASA and 34 patients stopped it 72 hours before extraction. Sixty-two of the patients were treated with 75 mg clopidogrel; these were also divided into two groups: 31 continued taking clopidogrel and 31 patients stopped it 72 hours before extractions. Extraction was performed under local anaesthesia as no more than 3 teeth per visit were extracted. Local haemostasis with gelatine sponge and/or suturing was used to control bleeding.Results: Mild bleeding was observed most frequently in the first 30 minutes, successfully managed by local haemostasis. Only 1 patient in the control and 1 in the experimental group receiving ASA reported mild bleeding in the first 24 hours, controlled by compression with gauze. No major haemorrhage requiring emergency or more than local haemostasis occurred. No statistically significant difference in bleeding between two groups was found.Conclusion: Single and multiple dental extractions in patients receiving acetylsalicylic acid or clopidogrel can be safely performed without discontinuation of the therapy with provided appropriate local haemostasis.
机译：背景：过度出血的风险通常促使医生在拔牙前中断抗血小板药物乙酰水杨酸和氯吡格雷，这使患者处于血栓形成不良事件的风险中。目的：评估持续抗血小板治疗的患者在拔牙过程中的出血风险。材料和方法：该研究包括130名年龄在18至99岁之间的患者（64名男性和66名女性）。 68％的患者接受了100 mg乙草胺酸（ASA）;将其分为两组：34例继续服用ASA，34例在提取前72小时停止服用。 62例患者接受了75 mg氯吡格雷治疗;它们也分为两组：31名继续服用氯吡格雷，31名患者在提取前72小时停止服用。提取是在局部麻醉下进行的，每次提取不超过3颗牙齿。用明胶海绵和/或缝合线进行局部止血以控制出血。结果：在最初的30分钟内，最常见的轻度出血是通过局部止血成功进行的。对照组中只有1名患者和实验组中有1名接受ASA的患者在头24小时内报告了轻度出血，这是通过纱布压迫来控制的。没有发生需要紧急治疗或超过局部止血的大出血。结论：两组患者在接受乙酰水杨酸或氯吡格雷治疗后，单次或多次拔牙可以安全地进行，而无需中断治疗并提供适当的局部止血。

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