대한장애인치과학회지 (The Journal of Korea Assosiation for Disability and Oral Health)

  • 제14권2호
  • /
  • Pages.102-105
  • /
  • 2018
  • /
  • 1738-8813(pISSN)
  • /
  • 2287-7142(eISSN)
대한장애인치과학회 (Korean Association for Disability and Oral Health)
권호 표지
DOI QR코드

DOI QR Code

혈우병A와 혈우병B 환자의 전신마취 하 치과치료

DENTAL MANAGEMENT UNDER GENERAL ANESTHESIA OF CHILDREN WITH HEMOPHILIA A AND HEMOPHILIA B

  • 김익환 (연세대학교 치과대학 소아치과학교실) ;
  • 박민지 (연세대학교 치과대학 소아치과학교실) ;
  • 이고은 (연세대학교 치과대학 소아치과학교실) ;
  • 이재호 (연세대학교 치과대학 소아치과학교실)
  • Kim, Ik-hwan (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Park, Minji (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Ko-Eun (Department of Pediatric Dentistry, College of Dentistry, Yonsei University) ;
  • Lee, Jae-Ho (Department of Pediatric Dentistry, College of Dentistry, Yonsei University)
  • 투고 : 2018.10.01
  • 심사 : 2018.11.18
  • 발행 : 2018.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

중등도의 혈우병 A 환아와 중증의 혈우병 B 환아가 응고인자 투여 후 전신마취 하에 각각 매복 과잉치 발거술 및 다수 유치의 우식치료를 받았다. 이와 같이 혈우병 환자의 치과치료 시에는 부족한 응고인자를 보충해주는 등의 응고인자 수준의 관리와 복잡한 의과적 처치 및 술 후 관리가 요구된다. 또한 치과치료 시 출혈을 유발되지 않도록 주의해야 하며 응급 상황 등에 대비하여 국소적 지혈 방법 등을 숙지하고 있는 것이 필요하다.

Hemophilia is an X-linked herediatry disorder. Hemophilia A is a defiency of factor VIII and hemophilia B (Christmas disease) is a deficiency of factor IX. The most widely used classification is based on plasma procoagulant levels, with people <1% factor defined as severe; 1 - 5% moderately severe; and >5% as mild. A 7 years old boy visited our clinic with chief complaint of impacted supernumerary tooth. This boy had severe hemophilia A. With the previous $ADVATE^{(R)}$ injection and factor VIII replacement, Extraction of supernumerary tooth was successfully done under General anesthesia. A 9 years old boy referred from local clinic for dental caries treatment. This boy had severe hemophilia B. With the preparation of $BeneFIX^{(R)}$ injection, dental treatment was done successfully under general anesthesia. It is often first detected by dental trauma. Since bleeding after dental treatment may cause severe or even fatal complications, people with hemophilia must be given special dental care. The treatment of the patients with either hemophilia A or hemophilia B involves the intravenous infusion to either control or prevent bleeding.

키워드

KDOHJY_2018_v14n2_102_f0001.png 이미지

Fig. 1. Hemostatic process. *: ADVATE®, **: BeneFIX®, ***: Transamin

Table 1. Patient information

KDOHJY_2018_v14n2_102_t0001.png 이미지

참고문헌

  1. Srivastava A, Brewer A, Mauser Bunschoten E, et al. : Guidelines for the management of hemophilia. Haemophilia, 19:1-47, 2013.
  2. O'Neil DW, Lowe JW, Mariscal R : Dentistry and the hemophiliac: a review of current literature, Part I. Compendium, 10:86-89, 1989.
  3. Growe G, Akabutu J, Ritchie B, et al. : Hemophilia and von Willebrand's disease: 1. Diagnosis, comprehensive care and assessment. Association of Hemophilia Clinic Directors of Canada. CMAJ, 153:19-25, 1995.
  4. Lim JE, Lee SE, Ahn HJ, et al. : Dental Treatment of Child with Hemophilia. Korean J Anesthesiol, 12:229-233, 2012. https://doi.org/10.17245/jkdsa.2012.12.4.229
  5. Jover Cervero A, Poveda Roda R, Bagan JV, et al. : Dental treatment of patients with coagulation factor alterations: An update. Med Oral Patol Oral Cir Bucal, 12:380-387, 2007.
  6. Scully C : Medical Problems in Dentistry E-Book, Elsevier Health Sciences, 2010.
  7. Kumar JN, Kumar RA, Varadarajan R, et al. : Specialty dentistry for the hemophiliac: Is there a protocol in place? Indian J Dent Res, 18:48-54, 2007. https://doi.org/10.4103/0970-9290.32419
  8. Bjorlin G, Nilsson IM : Oral surgery in patients with coagulopathies. Acta Odontol Scand, 21:99-139, 1963. https://doi.org/10.3109/00016356308993954
  9. Nilsson IM, Ahlberg A, Bjorlin G : Clinical experience with a Swedish factor IX concentrate. Acta Odontol Scand, 190:257-266, 1971.
  10. Ghosh K, Shetty S, Jijina F, et al. : Role of epsilon amino caproic acid in the management of haemophilic patients with inhibitors. Haemophilia, 10:58-62, 2004.
  11. Stubbs M, Lloyd J : A protocol for the dental management of von Willebrand's disease, haemophilia A and haemophilia B. Aust Dent J, 46:37-40, 2001. https://doi.org/10.1111/j.1834-7819.2001.tb00272.x
  12. Sindet-Pedersen S, Stenbjerg S : Effect of local antifibrinolytic treatment with tranexamic acid in hemophiliacs undergoing oral surgery. J Oral Maxillofac Surg, 44:703-707, 1986.
  13. Corrigan JJ Jr : Oral bleeding in hemophilia: treatment with epsilon aminocaproic acid and replacement therapy. J Pediatr, 80:124-128, 1972. https://doi.org/10.1016/S0022-3476(72)80471-2
  14. Lee JM, Nam SH, Kim YJ : Tooth extraction using replacement therapy and surgical splint in hemophiliac patient. J Korean Acad Pediatr Dent, 23:575-581, 1996.
  15. Frachon X, Pommereuil M, Berthier AM, et al. : Management options for dental extraction in hemophiliacs: a study of 55 extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 99:270-275, 2005. https://doi.org/10.1016/j.tripleo.2004.06.071
  16. Rickard KA : Guidelines for therapy and optimal dosages of coagulation factors for treatment of bleeding and surgery in haemophilia. Haemophilia, 1:8-13, 1995.
  17. Song JS, Choi BJ, Kim SO, et al. : Mild hemophilia a detected by delayed bleeding: A Case report. J Korean Dis Oral Health, 4:73-76, 2008.
  18. Park KS, Lee KH : Dental treatment of the patient with autism and hemophlilia a under general anesthesia a case report. J Korean Acad Pediatr Dent, 23:593-600, 1996.
  19. Geiser F, Meier C, Wegener I, et al. : Association between anxiety and factors of coagulation and fibrinolysis. Psychother Psychosom, 77:377-383, 2008. https://doi.org/10.1159/000151518
  20. Thrall G, Lane D, Lip GY, et al. : A systematic review of the effects of acute psychological stress and physical activity on haemorheology, coagulation, fibrinolysis and platelet reactivity: Implications for the pathogenesis of acute coronary syndromes. Thromb Res, 120:819-847, 2007. https://doi.org/10.1016/j.thromres.2007.01.004