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Doctoral Thesis
DOI
https://doi.org/10.11606/T.23.2021.tde-27082021-145351
Document
Author
Full name
Marilia Andrade Figueiredo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Ortega, Karem Lopez (President)
Franco, Juliana Bertoldi
Gallottini, Marina Helena Cury
Tenório, Jefferson da Rocha
Title in Portuguese
Avaliação dos compostos nitrogenados em saliva e sangue e do risco de sangramento durante exodontias em pacientes com insuficiência renal crônica
Keywords in Portuguese
Cirurgia Bucal
Insuficiência Renal Crônica
Sangramento
Ureia
Abstract in Portuguese
Acredita-se que, durante procedimentos invasivos, pacientes com insuficiência renal crônica (IRC) possam apresentar sangramento exacerbado e, talvez, de difícil controle, já que diversos fatores podem somar-se e precipitar esse desfecho. Este trabalho tem como objetivo mensurar o sangramento intra-operatório em exodontias de pacientes com insuficiência renal crônica, e identificar quais variáveis estariam relacionadas com um maior sangramento. Para este trabalho foi utilizada uma amostra de conveniência, constituída por pacientes com IRC em hemodiálise, selecionados de forma consecutiva, durante o período de junho de 2018 a novembro de 2019. Os pacientes eram de ambos os sexos, maiores de 18 anos de idade e apresentavam indicação de exodontia de dentes erupcionados. Durante o procedimento cirúrgico o sangue era aspirado para posterior mensuração da quantidade de sangue perdido. Foram atendidos 70 pacientes com IRC, mas a amostra final foi constituída por 43. Com relação aos exames laboratoriais apenas plaquetas apresentavam uma leve diminuição e a ureia e o fibrinogênio estavam aumentados. A mediana do volume de sangramento durante a exodontia foi de 4,38 ml e a do volume de sangramento por min de 0,27 ml/min. Nenhum paciente apresentou complicações de sangramento intra ou pós-operatórias. Não foi possível estabelecer nenhuma correlação entre o volume de sangramento e os exames laboratoriais ou os compostos nitrogenados. Concluímos que o sangramento intra-operatório em exodontias de pacientes com IRC não foi exacerbado e que não é possível correlacionar nenhuma variável com um maior sangramento.
Title in English
Evaluation of nitrogen compounds in saliva and blood and the risk of bleeding during extractions in patients with chronic renal failure
Keywords in English
Chronic hemorrhage
oral
Renal Insufficiency
Surgery
Urea
Abstract in English
The decrease in renal functions can compromise other organs and systems, leading to imbalances that may have clinical reflexes. It is believed that, during invasive procedures, patients with chronic renal failure (CRF) may have exacerbated bleeding and, perhaps, difficult to control, since several factors can add up and precipitate this outcome. This study aims to measure intraoperative bleeding in extractions of patients with chronic renal failure, and to identify which variables are related to greater bleeding. For this work, a convenience sample was used, consisting of patients with CRF on hemodialysis, selected consecutively, during the period from June 2018 to November 2019. The patients were of both sexes, over 18 years of age and had an indication of tooth extraction erupted. During the surgical procedure, blood was aspirated for later measurement of the amount of blood lost. Seventy patients with CRF were treated, but the final sample consisted of 43. Regarding laboratory tests, only platelets showed a slight decrease and urea and fibrinogen were increased. The median bleeding volume during extraction was 4.38 ml and the bleeding volume per min was 0.27 ml / min. No patient had complications of intra or postoperative bleeding. It was not possible to establish any correlation between the volume of bleeding and laboratory tests or nitrogen compounds. We conclude that intraoperative bleeding in extractions of patients with CKD is not exarcebated and that it is not possible to correlate any variable with greater bleeding.
 
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Publishing Date
2021-11-03
 
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