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目的:探讨阿司匹林对不同牙位残根拔牙创凝血影响的差异及原因。方法:选取接受单颗残根牙拔除的阿司匹林服药者160例(剂量100 mg/d,服药>2周),包括上下颌中切牙、侧切牙、尖牙、第一前磨、第二前磨牙、第一磨牙、第二磨牙、第三磨牙各10例。在其不停药情况下拔除患牙,根据拔牙创凝血分级表(Ⅰ、Ⅱ级凝血正常,Ⅲ~Ⅴ级出血量依次增加)进行评估,比较该药对不同牙位创面凝血影响的差异并进行分析。结果:1下颌前牙区1、2和上颌前牙区2残根牙拔除的患者,凝血均为Ⅰ、Ⅱ级,其余牙位残根拔除的患者均出现凝血Ⅲ、Ⅳ级,但Ⅴ级未见。2在前牙、前磨牙、磨牙残根拔除的患者中,上颌凝血正常者比例分别为90%、55%、43%,下颌该比例分别为97%、75%、43%。3凝血Ⅲ、Ⅳ级的患者患牙周围骨质较疏松,血供丰富,牙周膜面积较大,且易受手术损伤。结论:1除下颌前牙区1、2和上颌前牙区2,阿司匹林可造成其余牙位残根拔牙创出血增加。2阿司匹林对上颌拔牙创凝血的影响较下颌明显;对于上、下颌牙列,阿司匹林对前牙、前磨牙、磨牙创面的影响依次增加。3阿司匹林对拔牙创的抗凝作用受颌骨解剖结构及其血供、患牙牙周膜面积、拔牙方法等因素的影响。
Objective: To investigate the differences and reasons of aspirin on coagulation of different teeth during root extraction. Methods: A total of 160 aspirin recipients (single dose 100 mg / d, for 2 weeks) were enrolled in this study. They included upper and lower mandibular incisors, lateral incisors, canines, first premolar, Molars, first molars, second molars, third molars in 10 cases. The tooth was removed without stopping the medicine, and the blood coagulation grade was graded according to the tooth extraction (grade Ⅰ and Ⅱ were normal, and the grade Ⅲ ~ Ⅴ bleeding was increased in turn). The difference of coagulation between different teeth was compared. Analyze. Results: 1 In patients with mandibular anterior teeth 1 and 2 and maxillary anterior teeth 2 teeth, coagulation was grade Ⅰ and Ⅱ, coagulation Ⅲ and Ⅳ were found in the other teeth, but grade Ⅴ Not seen The proportion of patients with normal maxillary coagulation was 90%, 55% and 43% respectively in mandibular anterior teeth, premolar and molars. The rates of mandibular were 97%, 75% and 43% respectively. 3 coagulation Ⅲ, Ⅳ grade patients with loose teeth around the bone, rich in blood supply, periodontal membrane area larger, and vulnerable to surgical injury. CONCLUSIONS: 1 Aspirin can cause an increase of hemorrhage in the remaining tooth root remnant tooth extraction with the exception of mandibular anterior tooth area 1, 2 and maxillary anterior tooth area 2. The effect of aspirin on upper extremity tooth extraction coagulation more obvious than the lower jaw; As for the upper and lower jaw dentition, aspirin on the anterior teeth, premolar, molars wound increases in turn. 3 aspirin on the extraction of anticoagulant effect by the anatomy of the jaw and its blood supply, the affected periodontal membrane area, extraction methods and other factors.