肝硬変患者における口腔手術中の出血リスク：系統的レビュー

Risk of bleeding during oral surgery in patients with liver cirrhosis: A systematic review.

抄録

背景:

肝臓はほとんどすべての凝固因子の産生を担っているが、このことは肝硬変患者が歯科手術中に異常出血を起こすリスクを示しているのだろうか？

BACKGROUND: The liver is responsible for the production of almost all coagulation factors, but does this indicate a risk of developing unusual bleeding in patients with liver cirrhosis during dental surgery?

レビューされた研究の種類:

このシステマティックレビューにおいて、著者らはPreferred Reporting Items for Systematic Reviews and Meta-Analysesのチェックリストに従い、PubMed、Latin American and Caribbean Health Sciences Literature、Web of Science、Scopus、Cochraneのデータベースの検索を行った。

TYPES OF STUDIES REVIEWED: In this systemic review, the authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and performed a search of PubMed, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, and Cochrane databases.

結果:

7件の研究が組み入れ基準を満たした。サンプルサイズは23～318人、抜歯数は62～1,183本、血小板数は16,000～216,000/立方mm、国際標準化比は4未満であった。

RESULTS: Seven studies met the inclusion criteria. The sample sizes ranged from 23 through 318 participants, number of extracted teeth ranged from 62 through 1,183, platelet count ranged from 16,000 through 216,000 per cubic milimeter, and the international normalized ratio was less than 4. The prevalence of hemorrhagic events in the studies ranged from 0% through 8.9%, and almost all were controlled with local hemostatic measures.

結論と実際的意義:

歯科治療中、肝硬変患者は血小板数が減少し国際正常化比が上昇しているにもかかわらず、出血リスクは低い。

CONCLUSIONS AND PRACTICAL IMPLICATIONS: During dental treatment, patients with liver cirrhosis have a low bleeding risk in spite of the decreased number of platelets and increased international normalized ratio.