不停用阿司匹林拔牙术后分级止血的临床应用

Clinical application of hierarchical hemostasis based on bleeding risk for tooth extraction of the aspirin user without aspirin withdrawal

目的:评估长期单一小剂量口服阿司匹林患者的拔牙风险分级及相应拔牙后止血处理的临床效果。方法:采用病例对照研究方法,实验组282例,为长期单一口服阿司匹林患者;对照组350例,为无抗凝药物使用史的患者;对2组患者以同一标准将出血风险分为Ⅰ~Ⅳ级,实验组予以分级止血处理,对照组予以门诊常规止血,比较拔牙术后出血情况。各级风险拔牙术后需二次止血的比率,各类风险分别进行卡方检验。结果:各类风险的二次出血止血率统计学分析,实验组与对照组之间无明显统计学差异(P>0.05)。不停用阿司匹林拔牙的二次操作止血率,与常规门诊拔牙风险无明显差别。结论:在止血方法选用得当的情况下,患者无需停用阿司匹林即可拔牙,以防停药引起的其他系统并发症。

Objective:To evaluate the effects of hierarchical hemostasis based on bleeding risk for tooth extraction of the aspirin user without aspirin withdrawal. Methods:282 cases with long-term single oral aspirin use(experimental group) and 350 without aspirin use (control group) were included. Bleeding risk was classified as Ⅰ-Ⅳ grate according to the same standard for all the patients , the subjects in experimental group were treated by hierachial hemostatasis, the cases in control group were given routine hemostasis. Bleed ing situation after tooth extraction and the second hemostatic rates were compared by chi square test. Results:The second hemostatic rates of the subjects with the same bleeding risk level between experimental and control groups showed no significant statistical difference (P>0.05). Conclusion: Hierarchical hemostasis is effective in the treatment of bleeding risk for tooth extraction of the aspirin user without aspirin withrawal.