富血小板血浆在抗凝治疗患者拔牙术中的应用

目的:评价富血小板血浆局部应用对抗凝治疗患者拔牙术后出血及拔牙创愈合的影响。方法:选择抗凝治疗需拔牙患者48例随机分为实验组和对照组,另外随机选择从未经抗凝治疗拔牙患者20例作正常对照。拔牙前均行凝血酶原时间和国际标准化率检测。拔牙术后实验组拔牙创置自体富血小板血浆,对照组和正常对照组拔牙创行明胶海绵填塞、可吸收线缝合或填塞加缝合处理,比较三组术后出血情况及拔牙创愈合情况。结果:实验组术后轻度出血1例,对照组术后中度出血1例,轻度出血3例,正常对照组术后轻度出血1例,三组均未出现严重出血病例;10 d后拔牙创软组织愈合实验组优于对照组和正常对照组。结论:富血小板血浆局部应用能有效预防抗凝治疗患者拔牙术后出血,促进拔牙创软组织早期愈合。

The use of platelet-rich plasma in outpatient dental extraction for patients receiving anticoagulation therapy

Objective:To evaluate the clinical effect of a protocol using platelet-rich plasma(PRP) to prevent bleeding and accelerate regeneration in socket after dental extraction in patients treated with anticoagulant oral therapy.Method:Forty-eight patients who were treatedwith anticoagulant oral therapy randomly assigned to study and control groups and 20 patients who had never been on anticoagulant therapy serving as the negative control group were included in this trial.Before teeth extractions,all patients had a prothrombin time(PT) and the international normalized ratio(INR) determined.To gain hemostasis and primary closure,gelatin sponge and resorbable sutures were used in the control and negative control groups,and autologouse platelet-rich plasma(PRP) were used in the study group.postoperative bleeding and wound healing were correlated and recorded.Result:Only one patient had mild bleeding that was easy to control in the study group(4.2%) and the negative control group(5%),while one case had moderate bleeding that required treatment and 3 cases had mild bleeding in the control group(16.7%).There were no cases of postoperative serious bleeding problems in three groups.In relation to wound healing,the healing process in study group was superior to that of control group and negative control group.Conclusion:Multiple extractions can be performed in patients taking oral anticoagulant therapy without modification of oral anticoagulant treatment.Local use with autologouse PRP is an effective and safe procedure for dental extractions in such patients.