혈우병을 가진 어린이의 치과치료
Dental Treatment of Child with Hemophilia
임지은, 이수언, 안효정, 박재홍, 최성철,
소속 상세정보
임지은 ( Lim Ji-Eun ) - 경희대학교 치의학전문대학원 소아치과학교실
이수언 ( Lee Soo-Eon ) - 경희대학교 치의학전문대학원 소아치과학교실
안효정 ( Ahn Hyo-Jung ) - 경희대학교 치의학전문대학원 소아치과학교실
박재홍 ( Park Jae-Hong ) - 경희대학교 치의학전문대학원 소아치과학교실
최성철 ( Choi Sung-Chul ) - 경희대학교 치의학전문대학원 소아치과학교실
KMID : 0980220120120040229
Abstract
Severe한 혈우병 B 환아가 소아과에 입원하여 세계혈우병연맹(World Federation of Hemophilia, WFH) 지침서에 따라서 응고인자 수준을 유지하면서 다수의 발치를 포함한 관혈적 치과 치료를 받았다. 이와 같이 혈우병 환자에서 다수의 발치를 시행할 때 주기적인 혈액검사를 통한 응고인자 수준의 관리와 복잡한 의과적 처치가 요구된다. 따라서 다수의 발치가 요구되는 경우 전신마취 하에 가능한 모든 치과치료를 시행하는 것이 효과적이고 효율적인 방법이 될 수 있다.
Hemophilia, the most common of the inherited bleeding disorder, is the result of a deficiency of clotting factor. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. We report on the diagnosis and treatment of a 9-year-old boy having severe hemophilia visited our department with the chief complaints of pus discharge on the left lower molar region. In the clinical and radiographic examination, periapical abscess and dental caries were diagnosed. Considering complexity of the treatment and complication in the coagulation, it was decided to carry on the treatment under general anesthesia. Clotting factor IX concentrates were intended to provide 50-70% plasma level. Pulpectomy, resin restoration and Stainless steel crown were given under general anesthesia. Several teeth were extracted and the sockets were packed with Surgicel (Oxidized Regenerated Cellulose, Johnson and Johnson Co. Neuchatel, Switzerland) under general anesthesia. Transpalatal arch and lingual arch were given for maintaining the extracted space before discharged. For people with severe hemophilia, factor replacement is necessary before scaling, surgery or regional block injections. Therefore, if several extractions are needed, dental care under general anesthesia would be effective and efficient management.
키워드
Clotting factor; Dental treatment; Extraction; Hemophilia
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