使用新型口服用抗凝血劑對口腔外科手術之影響－學術綜論

Impacts of Novel Anticoagulants on Oral and Maxillofacial Surgery

袁章洲(Chang-Chou Yuan) ； 黃恰嘉(Yi-Chia Huang) ； 姜厚任(Ho-Ren Jiang) ； 林哲毅(Che-Yi Lin)

《臺灣口腔顎面外科學會雜誌》 26卷3期 (2015/09) Pp. 167-174

摘要

過去常用且對於手術深具出血影響之口服抗凝血劑之一為維生素K之拮抗劑，其缺點為狹窄的治療範園，易與其他藥物或食物產生交互作用，同樣劑量因個體不同而有濃度上之差異，因此需要定期抽血監測其藥物濃度避免因出血導致副作用產生。近幾年來針對非瓣膜性之心房顫動患者用來預防中風，及深部靜脈血梭，發展出新型口服用抗凝血藥物。優點為不需要定期抽血監測，有取代傳統可邁丁治療之趨勢。本篇文章主要針對於口服新型抗凝血劑患者，針對其藥理特性及相關手術提供緊急處理及處置應對原則做相關文獻的回顧。

關鍵字

新型口服抗凝血劑 ； 口腔顎面外科手術

並列摘要

In the past decades, the most common anticoagulation agent was vitamin-K antagonist, who plays an important role in surgery with bleeding risk. The disadvantages of vitamin-K antagonist include narrow therapeutic window, interactions with drugs and foods, and not dose dependent drug for every patient. So these patients need regular blood test for monitoring the concentration of drugs to avoid the bleeding risk. In recent years, a novel oral anticoagulation agent was developed for preventing stroke of non-valvular atrial fibrilliation and for the deep vein thrombosis patients. The benefit is no need of regular blood test. When patient use anticoagulation agent, this will have effect for the surgery including the bleeding risk in the oral and maxillofacial surgery inpatient and outpatient. We will focus on the novel anticoagulation agent with reviewing literatures about the pharmacotherapeutics and treatment policy of surgery, and the emergency treatment of bleeding with suggestions.

並列關鍵字

Novel oral anticoagulant agent ； Oral and maxillofacial surgery