房颤患者心电监护拔牙的临床研究

目的:对房颤患者不停用华法令、心电监护下拔牙问题进行分析研究,为其安全拔牙提供参考。方法:监测33例房颤患者拔牙前后及过程中血压、心率、心电图变化,进行对比分析,并观察术后出血情况。结果:32例患者完成手术。血压、心率在麻醉时及术中均明显升高(P<0.05),术后心率较术前显著降低(P<0.05)。3例术中出现室性早搏。所有患者术后拔牙创均无明显出血。结论:只要术前准备充分、术中严密监护、术后加强局部止血,长期口服华法令的房颤患者在不停药、不减量、局麻下施行拔牙术是安全可行的。

A study on dental extraction of atrial fibrillation patients under electrocardiographic monitoring

Objective：To discuss the experience in dental extraction under electrocardiographic monitoring for atrial fibrillation patients taking Warfarin. Methods： Thirty-three patients were included in this study. The changes of blood pressure, heart rate and electrocardiogram were recorded before, during and after operation. Postoperative bleeding complications were also observed. Results： Thirty-two patients were successfully completed dental extraction. Blood pressure and heart rate increased significantly during operation （P〈0.05）. Heart rate of post-operation decreased more significantly than pre-operation（P〈0.05）.Ventricular prema~re beat occurred in 3 patients. Postoperative bleeding was not found. Conclusion： Without stopping warfarin, dental extraction of atrial fibrillation patients could be carried out safely and effectively under local anaesthesia if only patients were monitored and hemostatic methods were taken.