诊断学理论与实践2013，Vol.12Issue(4)：443-447,5.DOI:10.3969/j.issn.1671-2870.2013.04.014
服用阿司匹林者血小板聚集率与残根拔除后出血的关联研究
A study on the relationship between platelet aggregation rate of aspirin users and bleeding risk after residual root extraction
摘要
Abstract
Objective To define the platelet aggregation rate of aspirin users undergoing single tooth (residual root)extraction without preoperative aspirin withdrawal and the reasonable time of preoperative aspirin suspension.Methods Ninety patients with cardiovascular and cerebrovascular disease taking aspirin for secondary prevention (age:50-80 years,course ＞ 2 week,dosage:100 mg/d) and undergoing single upper tooth (residual root) extraction were enrolled in this study.Patients were divided into 3 groups according to the tooth extracted(anterior tooth,premolar and molar).Light transmission aggregometry test using arachidonic acid (AA) as inducer was performed before tooth extraction.Socket coagulation classification table (class Ⅰ-Ⅲ,from ideal to undesirable) was used to evaluate the wound coagulation after extraction.The relationship between change of platelet aggregation rate caused by aspirin usage and bleeding risk of residual root extraction was analyzed.For cases with relatively high postoperative bleeding risk,the optimal cut-off AA inducer value was explored.Results ① All cases in anterior tooth group were of class Ⅰ.② In premolar group,3 cases with continued use of aspirin preoperatively were of class Ⅱ,other cases were of class Ⅰ ; the optimal cut-off AA inducer value was 11.5％.③ In molar group,4 cases with continued use of aspirin preoperatively and 1 case with preoperative 3 days aspirin suspension were of class Ⅱ,other cases were of class I ; the optimal cut-off AA inducer value was 16.5％.Conclusions For aspirin users (100 mg/d) who would undergo a single upper tooth (residual root) extraction:① Continued use of aspirin preoperatively is feasible for anterior tooth extraction because of the low bleeding risk.② For premolar extraction,AA inducer value≥ 11.5％ indicates a low bleeding risk and the value ＜ 11.5％ indicates a relatively high risk.For molar extraction,AA inducer value≥ 16.5％ indicates a low bleeding risk and the value ＜ 16.5％ indicates a relatively high risk.Continued use of aspirin preoperatively is feasible for cases with an estimated low bleeding risk; and suspension of aspirin for 3 days preoperatively should be implemented for cases with an estimated high risk.关键词
阿司匹林/血小板聚集率/拔牙/出血/光学比浊法血小板聚集率检测Key words
Aspirin/ Platelet aggregation rate/ Tooth extraction/ Bleeding/ Light transmission aggregometry (LTA)分类
医药卫生引用本文复制引用
陆萌萌,高益鸣..服用阿司匹林者血小板聚集率与残根拔除后出血的关联研究[J].诊断学理论与实践,2013,12(4):443-447,5.基金项目
上海市卫生局青年科研资助项目(20124Y059) （20124Y059）
