抗血栓治疗患者的牙科管理

A. P. Souza, F. D. Cavalcante, Eteíla de Souza Canto Silva, S. Santana, M. Peixoto, F. Peixoto
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引用次数: 0

摘要

心血管疾病是世界上常见的疾病,也是造成死亡的主要原因。据世界卫生组织估计,这些疾病每年造成约1730万人死亡,占世界总死亡人数的30%。在心血管疾病中,血栓形成性疾病是最常见的疾病之一。血栓治疗的药物策略,由于血小板和纤维蛋白的优势取决于血栓的类型,包括抗血小板药物、抗凝剂和纤维蛋白药物,尽管它们有不同的作用过程,但它们的目的是干扰血栓形成和维持的主要步骤,大大增加自发性或诱发性出血的风险。接受口服抗凝剂治疗的患者能够接受牙科手术的总体趋势是上升的,在治疗期间不需要任何中断或修改,但重点是局部止血的预防性手术。这种方法对于使用AAS的患者仍然存在争议,考虑到在手术前几天中断使用是一种谨慎的行动,以减少出血的风险,并且与抗凝剂不同,显然对患者没有损害。本研究的重点是在文献综述的基础上,利用SciELO、MedLine和Lilacs等电子数据库中发表的英文和葡萄牙语的书籍、文章和科学期刊,以及巴西卫生部和世界卫生组织等官方电子地址中的可用信息,描述为接受抗凝血、抗血小板或溶栓治疗的患者提供安全牙科援助所采用的程序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MANEJO ODONTOLÓGICO DE PACIENTES EM TERAPIA ANTITROMBÓTICA
The cardiovascular diseases are common and represent the cause of deaths in the world. According to World Health Organization, it is estimated that those are responsible for about 17, 3 million or 30% of total deaths in the world each year. Among cardiovascular diseases, the thrombotic disease is one of the most prevalent. Pharmaceutical strategies to the thrombosis treatment, due to the predominance of platelet and fibrin depending on the type of thrombus, include anti-platelets medicine, anticoagulant and fibrinolitical agents, even though they have different courses of action, they aim to interfere on main steps of forming and maintenance of blood clots, increasing substantially the risk of spontaneous or induced bleedings. The general trend is upward for patients who are being treated with oral anticogulant to be able to undergo dentistry procedures, with no need of any interruption or modification during therapy, yet with emphasis on preventive procedures of local hemostasis. This approach is still controversial to patients which make use of AAS, considering that the action of interrupting the usage some days before the procedure continues to be a prudent course of action in order to reduce the risk of hemorrhage, and differently from anticoagulants, apparently with no damages to the patient. This study focused on describing the procedures to be adopted for a safe dentistry assistance for patients undergoing anticoagulant, antiplatelet or thrombolytic therapy, based on literature review, using books, articles and scientific journals published in electronical databases such as SciELO, MedLine and Lilacs, in English and Portuguese, besides available information in official electronical addresses such as the Brazilian Ministry of Health’s and the World Health Organization’s.
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