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目的对口服阿司匹林肠溶片的患者实施拔牙术,分析、观察创面出血的控制效果。方法随机选取我院自2015年1月-2016年10月收治的长期口服阿司匹林肠溶片患者共66例,对其实施拔牙术,在患者实施拔牙术前40分钟,对不过敏的患者口服阿莫西林和甲硝唑,对过敏史的患者口服乙酰螺旋霉素,以钳拔术的方式进行拔牙,术后第一天、第三天复诊,保持口服与术前相同的消炎药3-5天,第7天复诊拆线,观察、分析其创面出血控制的效果。结果所有患者均顺利完成拔牙术,过程中未发生头晕、昏迷、昏厥等严重的并发症。在完成拔牙术后30分钟检查发现,66例患者均出现程度不一的出血或渗血,对出血的患者实施相应处理后止血。术后第一天复诊,有17例患者可见血肿或淤斑,其中13例患者可见无需处理的少许渗血,术后第二天复诊,仍有8例患者未见变化的血肿或淤斑。第7天拆线时,所有患者拔牙后的创面均能基本正常愈合,未发生干槽症。结论本研究表明,对于长期服用阿司匹林抗血小板凝聚的患者,在实施术前凝血功能检测的结果只能作为手术的参考。对于皮肤有淤斑或紫癜的应当考虑自发性出血倾向的可能,以及对于近期消化道或口腔有自发性出血的,需要暂停实施拔牙术。患者在服用阿司匹林的情况下,通过局部的有效处理,可以安全实施拔牙。
Objective To investigate the control effect of wound bleeding in patients with oral aspirin enteric-coated tablets. Methods A total of 66 patients with long-term oral aspirin enteric-coated tablets admitted to our hospital from January 2015 to October 2016 were enrolled in this study. Tooth extraction was performed on them. 40 minutes before the tooth extraction, the patients with no allergies Moxillin and metronidazole oral acetylspiramycin in patients with history of allergy to pull the way to pull the clamp, the first day after surgery, the third day of referral to maintain the same preoperative oral anti-inflammatory drugs 3-5 Day, the first 7 days referral stitches, observe, analyze the effect of wound bleeding control. Results All patients successfully completed dental extraction without any serious complications such as dizziness, coma and fainting. Thirty minutes after completion of the extraction procedure, all 66 patients showed varying degrees of bleeding or bleeding, and hemorrhagic patients were treated accordingly to stop bleeding. On the first postoperative day of follow-up, 17 patients showed hematoma or ecchymosis. Thirteen patients showed little bleeding without treatment and the second day after the follow-up. There were still 8 patients with no change of hematoma or ecchymosis. On the 7th day, the wounds of all the patients were basically normal after the removal of the thread, and dry socket did not occur. Conclusions This study shows that for long-term use aspirin anti-platelet aggregation in patients with coagulation tests before the implementation of the results can only be used as a reference for surgery. For the skin with ecchymosis or purpura should consider the possibility of spontaneous bleeding tendency, and for the recent gastrointestinal or oral spontaneous bleeding, the need to suspend the implementation of extraction surgery. In patients taking aspirin in the case, through effective local treatment, can be safely implemented tooth extraction.