血液透析患者における抜歯に関する臨床的検討

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  • Clinical evaluation of tooth extraction in hemodialysis patients undergoing antithrombotic therapy
  • ケツエキ トウセキ カンジャ ニ オケル バッシ ニ カンスル リンショウテキ ケントウ

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We report the clinical analysis of 33 hemodialysis patients who underwent tooth extractions (63 extractions in total) at Takai Hospital during the 4-year period from April 2007 to April 2011.<br>The patients were divided into two groups: those who were administered an antithrombotic agent (antithrombotic group; 20 cases; 39 extractions), and those who were not (non-antithrombotic group; 13 cases; 24 extractions). For both groups, the anticoagulant was switched to low-molecular-weight heparin or nafamostat mesilate for dialysis on the day before extraction. Local hemostasis was achieved in both groups with tight suturing and astriction. With respect to local inflammation prior to extraction, both groups involved mostly grade 0 cases. For post-extraction bleeding, both the antithrombotic and non-antithrombotic groups had 4 cases each with bleeding greater than grade 1. The 8 cases with post-extraction bleeding also had local inflammation greater than grade 2, with inflammation seen as the reason for the bleeding.<br>In conclusion, appropriate local hemostasis among hemodialysis patients undergoing antithrombotic therapy is essential for achieving hemostasis.

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