간이식 환자의 출혈 경향과 치과적 고려 사항

The Risk of Bleeding in Liver Transplant Patients and Dental Considerations

  • 박원서 (연세대학교 치과대학 통합진료학과) ;
  • 백윤재 (연세대학교 치과대학 통합진료학과) ;
  • 도레미 (단국대학교 치과대학 부속치과병원 통합진료과) ;
  • 김기덕 (연세대학교 치과대학 통합진료학과) ;
  • 정복영 (연세대학교 치과대학 통합진료학과) ;
  • 방난심 (연세대학교 치과대학 통합진료학과) ;
  • 윤희정 (연세대학교 치과대학 통합진료학과) ;
  • 유태민 (단국대학교 치과대학 부속치과병원 통합진료과)
  • Park, Wonse (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • Baik, Yoon-Jae (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • Doh, Re-Mee (Department of Advanced General Dentistry, Dental Hospital, Dankook University) ;
  • Kim, Kee-Deog (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • Jung, Bock-Young (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • Pang, Nan-Sim (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • Yun, Hee-Jung (Department of Advanced General Dentistry, Yonsei University College of dentistry) ;
  • You, Tae-Min (Department of Advanced General Dentistry, Dental Hospital, Dankook University)
  • 투고 : 2012.09.19
  • 심사 : 2012.09.28
  • 발행 : 2012.09.30

초록

Background: The major goal of dental management before and after liver transplantation is the prevention of bacteremia from an oral source that could lead to systemic infection. However dental treatment in liver transplant patients have the risk of infection and bleeding. so it is needed special dental consideration. Methods: 42 liver transplant candidates who visited department of Advanced General Dentistry in Yonsei University College of dentistry from March 1, 2010 to February 29, 2012 were selected. The clinical data of those patients were analyzed; coagulation status such as PT, INR, aPTT, platelet count before and 6 months after liver transplantation, dental infectious foci, time interval between dental visit and operation date of liver transplantation. Results: Before liver transplant, the patient's PT and INR was prolonged, and the platelet count was lower than normal range. But 6 months later from liver transplantation, most of the figures turned into a normal range. The dental infection foci were chronic periodontitis, dental caries, chronic apical periodontitis, root rest et al but we did extraction of 6 root rest before liver transplantation and postponed other treatment after liver transplantation due to bleeding and infection risk of patients. Because of insufficient interval between dental visit and operation date, 64.3% of patients could not finish the dental treatment. Conclusions: The patients before liver transplantation have the risk of bleeding. The treatment of those patient should be removal of only factors that can cause dental infections after transplantation and other treatment must be postponed until the stable period of the transplant that patient's condition has improved.

키워드

참고문헌

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