@article{oai:niigata-u.repo.nii.ac.jp:02000553,
 author = {永井, 孝宏 and Nagai, Takahiro and 児玉, 泰光 and Kodama, Yasumitsu and 黒川, 亮 and Kurokawa, Akira and 西川, 敦 and Nishikawa, Atsushi and 山田, 瑛子 and Yamada, Eiko and 田邊, 嘉也 and Tanabe, Yoshinari and 高木, 律男 and Takagi, Ritsuo},
 issue = {2},
 journal = {新潟歯学会雑誌},
 month = {Dec},
 note = {今回，1999年から2015年までの17年間に歯科観血的処置を行ったHIV感染者23名(89処置)を対象に，①患者に関する項目，②処置に関する項目，③周術期管理に関する項目，の3つについて検討した。①年度別処置患者数について，1999年から2007年の前半は年平均1.0例であったのに対し，後半は年平均6.4例と顕著に増加していた。男女比10.5:1で，年齢は18～63歳(平均44.2歳)であった。処置時のCD4陽性リンパ球数について，200/μl以上は9割，血中HIV-RNA量は検出限界以下が6割であった。約9割弱でARTが実施されており，合併疾患にB型肝炎3名，血友病とC型肝炎の重複症例が2名，糖尿病が1名いた。②診断は，齲蝕53例，根尖性歯周炎16例，埋伏智歯9例，辺縁性歯周炎5例と続き，処置内容は，普通抜歯72回，埋伏智歯抜歯9回，歯根端切除術3回などであった。③周術期管理について，歯科観血的処置は，外来・局所麻酔下49回，入院・局所麻酔下9回，入院・全身麻酔下および入院・静脈内鎮静法下がそれぞれ1回であった。1割で術後合併症を認め，その内訳は，後出血3例，抜歯後感染2例，ドライソケット1例であった。免疫状態が良好でウイルス量が検出限界以下では，歯科観血的処置を特別視する必要はないものの，最近のHIV感染症の増加および慢性疾患化を考えると，個々の病態を十分に理解し，適当な環境のもと適切な態度での対応が歯科医療従事者に求められていると推察された。, This study concerns the characteristics, treatment, and peri-operative management among 23 HIV-infected patients who underwent a total of 89 invasive dental procedures from 1999 to 2015. (1) In the first half of the study period between 1999 to 2007, there was average of 1.0 case per year. However, there was increasing to an average of 6.4 case per year in the second half between 2008 to 2015. Gender ratio was 10.5: 1(Male: Femal). Average of age was 44.2 years (18 to 63). At the treatment, 90% of cases maintained over 200/μl CD4 count. HIV-1 viral load was below limit of detection in 60% cases. Over 90% of cases were undergoing ART treatment. Three cases had hepatitis B infection, two cases had both hemophilia and hepatitis C, and one case had diabetes mellitus. (2) Regarding diagnosis, there were 53 dental caries, 16 root apical periodontitis, 9 third molar impactions, and 5 marginal periodontitis. Regarding treatment, there were 72 normal tooth extraction, 9 third molar extractions, and 3 apical root resections. (3) Regarding peri-operative management, there were 49 cases conducted under local anesthesia as outpatient, 9 cases conducted under local anesthesia as inpatient. There was one general anesthesia case and one intravenous sedation case, respectively. Postoperative complications occurred in 10% of cases: 3 cases of bleeding, 2 of infection after tooth extraction, and one including dry socket. In nearly future, invasive dental procedures among HIV-infected patients may increase at Niigata area. All dental staff are required to more fully understand each cases of individual HIV states, and to perform its under an appropriate environment, and to make adequate preparations for risk of blood exposure.},
 pages = {69--75},
 title = {HIV感染者における歯科観血的処置の臨床的検討},
 volume = {46},
 year = {2016}
}