Kontrola krvarenja kod oralnokirurških zahvata

master's thesis

• Title (english): Bleeding control in oral surgery procedures
• Author: Mirna Radočaj
• Mentor: Irina Filipović-Zore (mentor)
• Committee member: Irina Filipović-Zore (predsjednik povjerenstva)
• Committee member: Marko Vuletić (član povjerenstva)
• Committee member: Anja Baraba (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2022-07-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

Hemostaza je fiziološki proces zaustavljanja krvarenja. Čine ju četiri glavne faze: faza
vaskularne konstrikcije, faza stvaranja trombocitnog čepa, faza zgrušavanja i faza fibrinolize.
Na taj uravnoteženi proces hemostaze mogu utjecati određene bolesti i lijekovi. Antitrombotski
lijekovi koriste se u terapiji i prevenciji velikog broja cerebrovaskularnih i kardiovaskularnih
bolesti. Antitrombotske lijekove dijelimo na antikoagulantne i antitrombocitne lijekove.
Antikoagulantni lijekovi utječu na fazu koagulacije, a postoje peroralni (varfarin i novi
antikoagulantni lijekovi – dabigatran, rivaroksaban i apiksaban) i parenteralni antikoagulansi
(nefrakcionirani heparin i heparin niske molekularne težine). Antitrombocitni lijekovi utječu na
fazu agregacije trombocita, a najpoznatiji su predstavnici acetilsalicilna kiselina (aspirin),
dipiridamol i P2Y12 inhibitori (klopidogrel). Novi antikoagulantni lijekovi imaju poboljšana
farmakokinetska i farmakodinamska svojstva i u novije doba zamjenjuju varfarin jer su jednako
efikasni, ne zahtijevaju redovito praćenje i zbog kratkog poluživota imaju nisku šansu za
toksičnim reakcijama i obilnim krvarenjima. Antitrombotska terapija nikada se ne prekida bez
konzultacije s hematologom, a većina postoperativnih krvarenja može se zaustaviti lokalnim
mjerama hemostaze. Uvijek treba imati na umu da je rizik od tromboembolijskih ispada u
slučaju prekida terapije puno viši od rizika produljenog ili naknadnog krvarenja.

Abstract (english)

Hemostasis is a physiological process of stopping bleeding. It consists of 4 main phases: the
vascular constriction phase, the platelet plug formation phase, the coagulation phase and the
fibrinolysis phase. This balanced process of hemostasis can be affected by certain diseases and
drugs. Antithrombotic drugs are used in the treatment and prevention of a large number of
cerebrovascular and cardiovascular diseases. Antithrombotic drugs are divided into two groups:
anticoagulant and antiplatelet drugs. Anticoagulant drugs affect the coagulation phase. There
are oral (warfarin and new anticoagulant drugs dabigatran, rivaroxaban, and apixaban) and
parenteral anticoagulants (unfractionated heparin and low molecular weight heparin).
Antiplatelet drugs affect the phase of platelet aggregation, the most famous representatives
being acetylsalicylic acid (aspirin), dipyridamole and P2Y12 inhibitors (clopidogrel). New
anticoagulant drugs have improved pharmacokinetic and pharmacodynamic properties and
have recently replaced warfarin because they are equally effective, do not require regular
monitoring and have a low chance of toxic reactions and heavy bleeding due to their short halflife. Antithrombotic therapy is never discontinued without consulting a hematologist, and most
cases of postoperative bleeding can be stopped by local measures of hemostasis. It should
always be borne in mind that the risk of thromboembolic events in the event of discontinuation
of therapy is much higher than the risk of prolonged or subsequent bleeding.

• Keywords: oralnokirurški postupci; hemostaza; farmaceutski pripravci; krvarenje
• Keywords (english): Oral Surgical Procedures; Hemostasis; Pharmaceutical Preparations; Hemorrhage
• Language: croatian
• URN:NBN: urn:nbn:hr:127:172591
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2023-02-06 08:06:20