중증 간경변증 환자에서 발치창 과도 출혈부의 지속적 배농술을 통한 지혈 : 증례보고
BLEEDING CONTROL BY CONTINUOUS WOUND DRAINAGE OF ACTIVE BLEEDING SITES OF TEETH EXTRACTION WOUND IN A PATIENT WITH ADVANCED LIVER CIRRHOSIS : REPORT OF A CASE
모동엽, 유재하, 최병호, 김하랑, 이천의, 유미현,
소속 상세정보
모동엽 ( Mo Dong-Yub ) - 연세대학교 치과대학 구강악안면외과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 치과대학 구강악안면외과학교실
최병호 ( Choi Byung-Ho ) - 연세대학교 치과대학 구강악안면외과학교실
김하랑 ( Kim Ha-Rang ) - 연세대학교 치과대학 구강악안면외과학교실
이천의 ( Lee Chun-Ui ) - 연세대학교 치과대학 구강악안면외과학교실
유미현 ( Ryu Mi-Heon ) - 부산대학교 치의학전문대학원 구강병리학교실
KMID : 0355620090350060431
Abstract
There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.
키워드
Active oral bleeding;Dental extraction wound;Liver cirrhosis;Continuous wound drainage;Bleeding control
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