Experts' consensus on perioperative management of tooth extractions in patients receiving oral antithrombotic treatment
Hua Xi Kou Qiang Yi Xue Za Zhi. 2022 May 25;40(3):255-263.
doi: 10.7518/hxkq.2022.03.002.
[Article in
English,
Chinese]
Authors
Jian Pan
1
, Yang Xue
2
, Jihong Zhao
3
, Qing Zhou
4
, Duohong Zou
5
, Songling Chen
6
, Bing Han
7
, Nianhui Cui
8
, Xian Liu
1
, Liao Wang
1
, Kaijin Hu
2
Affiliations
- 1 State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
- 2 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases & Dept. of Oral Surgery, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China.
- 3 Dept. of Oral Surgery, Hospital of Stomatology, Wuhan University, Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan 430079, China.
- 4 Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110001, China.
- 5 Dept. of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China.
- 6 Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
- 7 Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, Changchun 130021, China.
- 8 Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & National Health Commission Research Center of Engineering and Technology for Computerized Dentistry & National Medical Products Administration Key Laboratory for Dental Materials, Beijing 100081, China.
Thromboembolic diseases, which comprise venous thromboembolic diseases and arterial thromboembolic diseases, have become the number one cause of death worldwide. To prevent or treat thrombosis, patients with thromboembolic diseases need to take antithrombotic drugs, which would increase the risk of bleeding during and after surgery. Tooth extraction is the most common operation in oral and maxillofacial surgery clinics. Although patients given oral antithrombotic drugs do not need to undergo drug withdrawal, the perioperative management of such patients remains confusing to most clinicians. Moreover, the potential risk factors for bleeding warrant further study. To improve the clinicians' knowledge of perioperative management for patients subjected to tooth extractions with oral antithrombotic drugs, experts have drafted this consensus focusing on preoperative bleeding risk assessment, intraoperative operating norms, and postoperative care to summarize the points needing attention.
血栓栓塞性疾病包括静脉血栓栓塞性疾病和动脉血栓栓塞性疾病，已成为导致全球人口死亡的第一因素，这类患者需要服用抗栓药物对血栓形成进行防治，但在接受外科手术时其出血风险随之增加。拔牙手术是口腔外科门诊最常见的手术，尽管目前普遍认为口服抗栓药物的患者行拔牙手术时无需停药，但这类患者的围手术期管理依旧困惑着大部分口腔外科医师，一些潜在的出血危险因素也需要进一步深入研究。为了提高口腔外科医师对口服抗栓药物拔牙患者的围手术期管理能力，最大程度保障患者健康，相关专家起草本共识，从术前出血风险评估、术中操作规范和术后护理等方面总结相关临床经验，以期为广大同行提供参考。.
Keywords:
antithrombotic drugs; experts’ consensus; perioperative management; tooth extraction.
Grants and funding
[基金项目] 四川省干部保健科研课题（川干研2019-901）；四川大学华西口腔医院探索与研发项目（LCYJ2019-1）