拔牙围手术期预防性使用抗生素对术后并发症影响的研究进展

Research progress on the effects of prophylactic antibiotics on postoperative complications during the perioperative period of tooth extraction

拔牙术后可能发生肿胀、出血、感染、干槽症等并发症。为了预防或减少并发症的发生,医生常使用抗生素治疗。但当前对于拔牙围手术期是否使用抗生素仍然存在争议。目前,阿莫西林和阿莫西林/克拉维酸是拔牙围手术期最常用的抗生素。目前没有明确的证据表明抗生素给药时间(术前、术后或两者)对于预防术后并发症的发生很重要,而术后抗生素持续使用时间中位数为3~4 d。根据患者的全身情况以及患牙所处位置的不同,拔牙围手术期患者使用抗生素存在差异。本文将从抗生素的种类、使用原则、时间和使用方式,以及抗生素的管理等方面进行综述,以便为临床医生应对拔牙术后并发症提供参考。

Complications,such as swelling,bleeding,infection,and dry socket,may occur after tooth extraction.Dentists often apply antibiotic treatment to reduce or prevent these complications.However,whether to use antibiotics during the perioperative period of tooth extraction remains controversial.Amoxicillin and amoxicillin/clavulanate combinations are the most frequently used antibiotics in the perioperative period of tooth extraction.No clear evidence has shown that the using time of antibiotic administration(preoperative,postoperative,or both)has significant effect on complication prevention,but the median postoperative duration is always 3-4 days after operation.The use of antibiotics depends on patients’general condition and the locations of affected teeth during the perioperative period of tooth extraction.This review mainly focuses on antibiotic types,use principles,time,methods,and antibiotic administration to provide reference for alleviating complications after tooth extraction.