口服抗血栓药物患者拔牙术后出血倾向及危险因素的临床对照研究

doi:10.19439/j.sjos.2025.02.006

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (2): 146-151.doi: 10.19439/j.sjos.2025.02.006

口服抗血栓药物患者拔牙术后出血倾向及危险因素的临床对照研究

罗奇¹, 朱珠², 石欢¹, 周琴^1#, 俞创奇^1#

1.上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.上海交通大学医学院附属第九人民医院老年科,上海 200011

收稿日期:2024-03-21 修回日期:2024-05-10 出版日期:2025-04-25 发布日期:2025-05-15
通讯作者: 周琴,E-mail: qin_zq@163.com;俞创奇,E-mail: yuchuangqi2017@163.com。^#共同通信作者
作者简介:罗奇（1998-）,男,博士研究生,E-mail: 1505080492@qq.com
基金资助:
国家自然科学基金青年项目（32000973）

A clinical control study of bleeding tendency and risk factors in patients with oral antithrombotic drugs after dental extractions

Luo Qi¹, Zhu Zhu², Shi Huan¹, Zhou Qin¹, Yu Chuangqi¹

1. Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Gerontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2024-03-21 Revised:2024-05-10 Online:2025-04-25 Published:2025-05-15

摘要/Abstract

摘要： 目的：探讨口服抗血栓药物的患者与非用药患者拔牙术后出血倾向及相关危险因素,为拔牙手术围术期管理提供参考。方法：纳入2023年3月—6月于上海交通大学医学院附属第九人民医院心血管病拔牙专科门诊就诊的患者进行队列研究。根据是否服用抗血栓药物,将患者分为试验组（用药组）和对照组（不用药组）,在心电监护下拔牙并随访术后出血情况,分析出血发生率及相关危险因素。采用SPSS 20.0软件包对数据进行统计学分析。结果：纳入患者645例,其中,用药组305例,不用药组340例。用药组17例（5.6%,17/305）发生出血事件,不用药组1例(0.3%,1/340)发生出血事件,2组有显著差异（P<0.01）。二元logistic回归分析发现,高龄（OR：4.089,95%CI：1.351~12.374,P=0.013）对术后出血产生显著的正向影响。结论：口服抗血栓药物和高龄是心血管病患者拔牙术后出血的危险因素。

关键词: 口服抗栓药物, 拔牙术后出血, 危险因素, 高龄

Abstract: PURPOSE: To explore the bleeding tendency and related risk factors of patients with or without oral antithrombotic drugs after tooth extraction, in order to provide theoretical reference for perioperative management of tooth extraction. METHODS: A cohort study was conducted among patients who attended the Cardiovascular Tooth Extraction Specialist Clinic of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2023 to June 2023. The patients were divided into experimental group (medication group) and control group (no medication group) according to whether they took antithrombotic drugs for a long time. Teeth extraction was performed under ECG monitoring and postoperative bleeding was followed up to analyze the incidence of bleeding and related risk factors. SPSS 22.0 software package was used for data analysis. RESULTS: A total of 645 patients were included, including 305 patients in the medication group and 340 patients in the non-medication group. Bleeding events occurred in 17 cases (5.6%, 17/305) in the medication group and 1 (0.3%, 1/340) in the non-medication group, with significant difference between the two groups (P<0.01). Binary logistic regression analysis showed that old age (OR: 4.089, 95%CI: 1.351-12.374, P=0.013) had a significant positive effect on postoperative bleeding. CONCLUSIONS: Oral antithrombotic drugs and advanced age are the risk factors for postoperative bleeding in patients with cardiovascular diseases undergoing tooth extractions.

Key words: Oral antithrombotic drugs, Bleeding after tooth extraction, Risk factor, Advanced age

中图分类号:

R782.11

罗奇, 朱珠, 石欢, 周琴, 俞创奇. 口服抗血栓药物患者拔牙术后出血倾向及危险因素的临床对照研究[J]. 上海口腔医学, 2025, 34(2): 146-151.

Luo Qi, Zhu Zhu, Shi Huan, Zhou Qin, Yu Chuangqi. A clinical control study of bleeding tendency and risk factors in patients with oral antithrombotic drugs after dental extractions[J]. Shanghai Journal of Stomatology, 2025, 34(2): 146-151.

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口服抗血栓药物患者拔牙术后出血倾向及危险因素的临床对照研究

A clinical control study of bleeding tendency and risk factors in patients with oral antithrombotic drugs after dental extractions

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