Departmental Bulletin Paper 特発性血小板減少性紫斑病患者に対し,γ-グロブリン大量療法施行後に抜歯を行った1例

稲葉, 有希  ,  香川, 智世  ,  高森, 翔子  ,  渋谷, 亜佑美  ,  野井, 将大  ,  足立, 健  ,  村上, 拓也  ,  浅沼, 伸也  ,  肥後, 智樹  ,  山本, 学

29 ( 1 )  , pp.36 - 39 , 2016-03-09 , 滋賀医科大学雑誌編集委員会
The idiopathic thrombocytopenic purpura (ITP) does not accept the clear underlying disease that can become the cause and the internal use of the drug, and the ingurgitation of the platelet aggravates it by an appearance of the antiplatelet autoantibody and is a disease to produce thrombopenia. Therefore the bloody measures of the patients with ITP are very likely to be the intraoperative and postoperative bleeding. We extracted teeth under high-dose gamma-globulin therapy for patient with ITP. It was 39,000/µl, and, at the time of the first medical examination, the number of the platelets of the patient did not accept more than number of the platelets 50,000/µl recommended on the occasion of tooth extraction. Therefore, for five days from the first day after hospitalization to the fifth day, we gave an intravenous drip containing four bottles of Kenketu glovenin○R-I for I.V. injection 5000mg infusions with 30 ml/h. At the time of tooth extraction, we made a hemostasis floor considering the possibility that it became hard to stop bleeding. Because the number of the platelets was 63,000/µl and became more than 50,000/µl, we extracted teeth after eight days of hospitalization. In the case of the tooth extraction of the ITP patient, we think that it is important to consult doctors of hematology and to perform appropriate pre-treatment, to give local hemostasis treatment for possibility of the intraoperative and postoperative bleeding, to prepare for a suture and an electric scalpel, a gelatine sponge for hemostasis, a hemostasis floor appropriately.

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