阿司匹林对老年人拔牙术后出血影响的临床观察

摘要

Objective To investigate the feasibility of continuation of aspirin before tooth extraction in the elderly.Methods The patients enrolled in this study were the elderly requiring a single non-impacted tooth extraction.300 elderly outpatients used lidocaine local infiltration anesthesia,200 patients without using aspirin before tooth extraction served as control group Ⅰ,100 patients with prolong use of aspirin before tooth extraction as observation group Ⅰ.300 elderly outpatients used compound articaine local infiltration anesthesia,200 patients without using aspirin before tooth extraction served as control group Ⅱ,100 patients with prolong use of aspirin before tooth extraction as observation group Ⅱ.Bleedings at 5,10,30 min,24 h after tooth extraction were observed and the relationship between postoperative bleeding and intake of aspirin was analyzed.Results There was no significant difference at 5,10,30 min,24 h in postoperative bleeding after extraction between control group Ⅰ and observation group.The incidence of bleeding of observation group Ⅱ after tooth extraction at 5 min was higher than that of control group Ⅱ and there was no significant difference at 10,30 min,24 h between the two groups.Conclusions Continuation of aspirin have no influence on postoperative bleeding.Therefore we suggest that there was no indication to discontinue aspirin for the elderly before a single non-impacted tooth extraction.%目的 探讨老年人拔牙术前不停服阿司匹林的可行性.方法 600例均为拔除非阻生单颗牙的60岁以上患者,300例使用利多卡因局麻,其中200例未服用阿司匹林者为空白对照组Ⅰ,100例长期服用阿司匹林且术前不停药者为观察组Ⅰ；300例使用复方阿替卡因局麻,其中200例未服用阿司匹林者为空白对照组Ⅱ,100例长期服用阿司匹林且拔牙术前不停药者为观察组Ⅱ.观察研究对象拔牙创不同时间段出血情况,分析口服阿司匹林对拔牙术后不同时间段出血的影响.结果 观察组Ⅰ与空白对照组Ⅰ拔牙术后5、10、30 min、24 h出血比较,差异均无统计学意义(P＞0.05)；观察组Ⅱ拔牙术后5 min出血发生率(19.0％)显著高于空白对照组Ⅱ(6.5％),但两组拔牙术后10、30 min、24 h出血比较,差异均无统计学意义(P＞0.05).结论 口服阿司匹林对老年人非阻生单颗牙拔除术后出血无影响,拔牙术前可不停服阿司匹林.