Lokal Anestezi Altında Oral Cerrahi Prosedür Uygulanan Hastaların Preoperatif Koagülasyon Değerlerinin Araştırılması

Yıl 2019, Cilt: 5 Sayı: 3, 1696 - 1710, 31.12.2019

Bilal Ege Eldar Najafov

https://doi.org/10.30569/adiyamansaglik.609703

Öz

Amaç: Bu çalışmanın amacı lokal anestezi altında oral cerrahi işlem geçiren
hastaları preoperatif koagülasyon değerlerinin araştırılmasıdır.

Gereç ve Yöntem: Çalışmaya 2017-2018 tarihleri arasında Adıyaman Üniversitesi Diş
Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi Kliniği’ne çeşitli nedenlerden
dolayı başvuran ve yapılan muayene sonucu kendisine lokal anestezi altında
cerrahi girişim uygulanan 1598 hasta dahil edildi. Hastalara ait yaş, cinsiyet
ve aktif parsiyel tromboplastin zamanı (APTT), protrombin zamanı (PT) ve
uluslararası normalleştirilmiş oran (INR) gibi koagülasyon değerleri kaydedildi
ve istatistiksel olarak analiz edildi.

Bulgular: Çalışmaya dahil edilen hastaların yaş aralığı 11-92 arasında
değişmekteydi ve yaş ortalaması 30,51±11,09 idi. Bu hastaların %63,06’sı
(n=1007) kadın, %36,94’ü (n=591) erkekti. Cinsiyete göre dağılımda başvuran
toplam kadın hasta sayısı erkeklere kıyasla daha fazlaydı. Tüm hastalar alt yaş
grupları (0-20, 21-40, 41-60, >60) bakımından incelendiğinde her iki
cinsiyette özellikle 0-20 ile 21-40 yaş gruplarında istatistiksel olarak
anlamlı farklılık bulundu (p<0.05). 40 yaş üstü gruplarda ise anlamlı
farklılık bulunmadı (p>0.05). İncelenen koagülasyon değerlerinin hepsinde
normal sınırların dışında seyreden değerler görüldü. Bunlardan APTT ve PT (%)
değerlerinde düşük değerler; INR ve PT (sn) değerlerinde ise yüksek değerler
sayıca daha fazla bulundu. Normal olmayan bu değerler cinsiyet bakımından
incelendiğinde PT (%) hariç diğerleri erkeklere nazaran kadınlarda istatistiksel
olarak anlamlı şekilde daha fazla görüldüğü bulundu. Dört koagülasyon
parametresine ait normal olmayan bu değerler yaş grupları bakımından ise
istatistiksel olarak anlamlı şekilde en fazla 21-40 yaş arasında görüldüğü
tespit edildi (p<0,001).

Sonuç: Lokal uygulanan cerrahi işlemler öncesinde preoperatif koagülasyon
testlerinin alınması özellikle detaylı tıbbi anamnez alınamayan hastalarda önem
arz etmektedir.

Anahtar Kelimeler

APTT, INR, PT, preoperatif koagülasyon testleri, oral cerrahi

Destekleyen Kurum

Bulunmamaktadır.

The Investigation Preoperative Coagulation Values of Patients Undergoing Oral Surgical Procedure Under Local Anesthesia

Öz

Objective: The aim in this study was to investigate preoperative coagulation
values of patients undergoing oral surgery under local anesthesia.

Material and Method: The study included 1598 patients who presented to
the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry at
Adıyaman University between 2017 and 2018 for various reasons and underwent
surgery under local anesthesia based on examination. The patients’ age and
gender as well as their coagulation values such as activated partial
thromboplastin time (APTT), prothrombin time (PT) and international normalized
ratio (INR) were recorded and analyzed statistically.

Results: The age range of the patients included in the study ranged between 11 and
92, and their mean age was 30.51 ± 11.09. Of these patients, 63.06% (n = 1007)
were female, and 36.94% (n = 591) were male. The total number of female
patients admitted was more than that of the male patients in terms of the
distribution by gender. When the number of patients admitted were examined in
terms of age groups (0–20, 21–40, 41–60, > 60), statistically significant
differences were found especially between the ages 0–20 and 21–40 in both
gender (p <0.05). No significant differences were found in groups over the
age of 40 (p > 0.05). Values outside the normal range were observed in all
of the coagulation values examined. Among these, APTT and PT (%) values that
were lower than the normal and INR and PT (s) values that were higher than the
normal were found to prevail. An examination of these abnormal values in terms
of gender revealed that the values other than PT (%) were found to be statistically
significantly higher in women, compared to men. In terms of age groups, these
abnormal values belonging to the four coagulation parameters were found to be
statistically significantly the highest among the people who were 21–40 years
old (p < 0.001).

Conclusion: Taking preoperative coagulation tests prior to locally applied
surgical procedures is especially important in patients for whom detailed
medical history cannot be obtained.

Anahtar Kelimeler

APTT, INR, PT, preoperative coagulation tests, oral surgery

Kaynakça

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