摘要：

目的：探讨心脏瓣膜置换术后服用抗凝剂的患者，行拔牙术的围手术期用药及安全性。方法：对南京市第一医院口腔科于2019年1月至2021年12月心脏瓣膜置换术后需拔除磨牙的患者采用病例对照研究。研究组（n=66例）为心脏瓣膜置换术后服用华法林行抗凝治疗的患者；对照组（n=150例）为未使用抗凝药物使用者。2组患者在进行围手术期用药及止血处理后，比较其拔牙后出血及创口愈合情况。结果：2组患者术后出血率、术后7 d拔牙创愈合情况比较，差异无统计学意义（P>0.05）。结论：对服用抗凝剂后需要拔牙的患者采用低分子肝素替代治疗，既能保证围手术期的安全，又可预防因停药导致的并发症。

关键词: 心脏瓣膜置换, 华法林, 抗凝治疗, 拔牙术

Abstract:

Objective: To investigate the application and security of anticoagulants during the perioperative period of tooth extraction in patients after heart valve replacement. Methods: A case-control study was carried out on patients with molar teeth extraction from the Department of Stomatology, Nanjing First Hospital from January 2019 to December 2021. The patients in the research group (n=66) took warfarin anticoagulation after heart valve replacement; the control group consisted of 150 patients didn't take anticoagulant. Perioperative medication and hemostasis were performed to compare bleeding and wound healing after tooth extraction. Results: There was no significant difference between the two groups in the bleeding rate after operation and the healing of tooth extraction wounds 7 days after operation (P>0.05). Conclusion: The replacement therapy with low molecular weight heparin can not only ensure the safety of the perioperative period, but also prevent the complications caused by withdrawal of the drug.

Key words: heart valve replacement, warfarin, anticoagulant therapy, tooth extraction

中图分类号: 

• R782