PDF(Pubmed)
Abstract：
This network meta-analysis was done to thoroughly evaluate the available literature on the use of different hemostatic agents for dental extraction in patients under oral antithrombotic therapy, aiming to identify the agent with the best/worst performance in bleeding control. Considering that such patients have a higher risk of bleeding, choosing the right hemostatic is essential. Twenty-three randomized clinical trials articles were included after completing the literature search. Cyanoacrylate tissue adhesive showed a reduction in the odds of postoperative bleeding events compared with conventional methods (i.e., gauze/cotton pressure, sutures), with a tendency toward a statistical significance (OR 0.03, P = 0.051). Tranexamic acid was the only agent that demonstrated a significantly lower risk of developing postoperative bleeding events (OR 0.27, P = 0.007). Interestingly, chitosan dental dressing and collagen plug had the shortest time to reach hemostasis. However, they ranked last among all hemostatic agents, regarding bleeding events, revealing higher odds than conventional measures. Therefore, it is concluded that the use of cyanoacrylate tissue adhesive and tranexamic acid gives favorable results in reducing postoperative bleeding events following dental extractions. Although chitosan dental dressing and collagen exhibited a faster time to reach hemostasis, they led to a higher occurrence of bleeding events.
摘要：
这项网络荟萃分析旨在全面评估现有文献中关于口服抗血栓治疗患者使用不同止血剂进行拔牙的情况。旨在确定在出血控制方面表现最佳/最差的药物。考虑到这些患者有更高的出血风险，选择正确的止血剂至关重要。在完成文献检索后，纳入了23篇随机临床试验文章。与常规方法相比，氰基丙烯酸酯组织粘合剂显示术后出血事件的几率降低（即，纱布/棉压力，缝线),具有统计学意义的趋势（OR0.03，P=0.051）。氨甲环酸是唯一显示术后出血事件发生风险显著降低的药物(OR0.27,P=0.007)。有趣的是,壳聚糖牙科敷料和胶原蛋白塞止血时间最短。然而,它们在所有止血剂中排名最后，关于出血事件，揭示比传统措施更高的几率。因此,结论是，使用氰基丙烯酸酯组织粘合剂和氨甲环酸在减少拔牙后的术后出血事件方面具有良好的效果。虽然壳聚糖牙科敷料和胶原蛋白显示更快的时间达到止血，它们导致了更高的出血事件发生率.
