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

Korean Association for Disability and Oral Health (대한장애인치과학회)
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INTERDISPLINARY CARE OF A PATIENT WITH APLASTIC ANEMIA : REPORT A CASE

재생불량성 빈혈 환자의 범학문적 접근 및 관리

  • Lee, Young Eun (Department of Pediatric Dentistry, KyungHee University Dental Hospital) ;
  • Park, Jae-Hong (Department of Pediatric Dentistry, KyungHee University Dental Hospital) ;
  • Kim, Kwang Chul (Department of Pediatric Dentistry, KyungHee University Dental Hospital) ;
  • Lee, Soo Eon (Department of Pediatric Dentistry, KyungHee University Dental Hospital)
  • 이영은 (경희대학교 치과병원 소아치과) ;
  • 박재홍 (경희대학교 치과병원 소아치과) ;
  • 김광철 (경희대학교 치과병원 소아치과) ;
  • 이수언 (경희대학교 치과병원 소아치과)
  • Received : 2013.08.26
  • Accepted : 2013.12.01
  • Published : 2013.12.31
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Abstract

Aplastic anemia (AA) is a blood dyscrasia characterized by hypocelluar bone marrow and peripheral blood pancytopenia. Symptomatology depends on the severity of pancytopenia. Patients with AA are susceptible to infection because of agranulocytosis. Hemorrhage caused by thrombocytopenia can be fetal to these patients. Therefore dental procedure potentially can cause serious complications and should be applied with caution. A 6-year-old boy with moderate aplastic anemia was referred to treat dental caries. General dental procedure including resin filling, preformed crown, pulpectomy and extraction was performed under sedation. Combination of modalities such as platelet transfusion, oral hygiene instruction, and dental prophylaxis was also implemented. In this report, the dental and medical management of a patient with AA was presented. Interdisciplinary care should be administered to patients with AA.

본 증례에서는 재생불량성 빈혈 환자의 치료에 있어 감염 가능성과 출혈 가능성을 고려하였으며 의과적 관리와 병행한 치과 치료를 성공적으로 시행하였다. 재생불량성 빈혈 환자의 사망원인은 감염과 출혈이 주를 이루므로 치과의사는 치료하기 전 이와 관련된 혈핵학적 특성을 알아야 하며, 가능한 치과 치료의 범위와 개입 시기를 이에 기반을 두어 판단하여야 한다. 치과 치료 전 혈소판 수치와 절대 호중구수를 고려하여 수혈과 예방적 항생제의 필요 여부를 결정하여야 할 것이다. 또한, 이러한 환자에 있어 예방치료와 구강 위생 관리는 일반 환자에서 중요하다. 주기적 검진 및 구강 위생에 대한 교육이 보다 강조되어야 할 것이다.

Keywords

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