ĐẶC ĐIỂM LÂM SÀNG VÀ TÌNH TRẠNG CHẢY MÁU SAU NHỔ RĂNG Ở BỆNH NHÂN SỬ DỤNG THUỐC KHÁNG KẾT TẬP TIỂU CẦU TẠI BỆNH VIỆN ĐA KHOA BÀ RỊA

Abstract

Background: Antiplatelet therapy (APT) plays a crtitical role in the treatment and prevention of cardiovascular events. However, dental extraction in patients receiving APT poses a clinical dilemma between the risk of prolonged bleeding if therapy is continued and the risk of thrombotic cardiovascular complications if therapy is discontinued. Objectives: To describe clinical characteristics and post-extraction bleeding outcomes in patients receiving APT compared with a control group. Materials and methods: A controlled clinical study was conducted on 210 patients (105 in the APT group and 105 in the control group), aged ≥40 years, treated at the Department of Oral and Maxillofacial Surgery, Ba Ria General Hospital, from September 2024 to August 2025. Results: The two groups were comparable in terms of age, sex, blood pressure, extraction indications, anesthetic dosage, and extraction time. In the APT group, the majority of patients were prescribed clopidogrel (62.9%), most commonly for chronic ischemic heart disease (67.6%). Periodontitis was the leading cause of extraction. The mean hemostasis time after extraction was significantly longer in the APT group compared with controls (p < 0.001). Furthermore, the proportion of patients with persistent bleeding at follow-up time points was higher among those on dual antiplatelet therapy compared with single therapy. At 60 minutes post-extraction, complete hemostasis was observed in all patients receiving antiplatelet therapy. Conclusion: Continuing APT during tooth extraction increases bleeding duration and frequency, particularly with dual therapy. However, most cases were effectively controlled with local hemostatic methods. Tooth extraction can be performed safely under APT if appropriate hemostatic techniques and careful postoperative monitoring are applied.