腦室腹腔引流術患者之牙科治療及注意事項 －病例報告

Dental Treatment in Patients with Ventriculoperiotoneal Shunt: A Case Report

蔡璧慧(Pi-Hui Tsai) ； 林孝禺(Shiao-Yu Lin) ； 蔡蔭玲(Aileen Tsai)

《臺灣兒童牙醫學雜誌》 3卷2期 (2003/06) Pp. 93-97

https://doi.org/10.6319/TJPD.2003.3(2).5

摘要

水腦為一種常見的胎兒缺陷，大多因為感染、顱內出血或腦部腫瘤所引起。治療水腦的常用方法為置放一個引流器將腦脊髓液作引流。最常見的兩種引流術式為腦室心房引流術 (Ventriculoatrail, VA shunt)及腦室腹腔引流術 (Ventriculoperitoneal, VP shunt)。本病例為一四歲女童，過去有水腦之病史合併裝有一腦室腹腔引流管，因多顆蛀牙而前來求診。經口腔檢查發現口腔衛生狀況不佳且有多顆無法復形之牙齒。牙科方面的考量為預防引流管的感染及拔除多顆牙齒後咬合功能的恢復。本文將針對裝置不同引流管之病患在作牙科治療前，是否給予抗生素預防感染作討論。

關鍵字

水腦 ； 腦室腹腔引流術 ； 抗生素預防感染

並列摘要

Hydrocephalus is a common childhood birth defect. It is frequently acquired secondary to infection, intracranial bleeding or brain tumor. The standard treatment for hydrocephalus is placement of a shunt to drain the cerebrospinal fluid. The two most commonly used shunt systems are ventriculoatrial (VA) shunt and ventriculoperiotoneal (VP) shunt. This report presents that a four-year-old girl with VP shunt was brought in with multiple deep caries, and medical history of hydrocephalus. Oral exam revealed poor oral hygiene, multiple nonrestorable teeth. Treatment considerations were to prevent infection of shunt and to restore occlusal function after teeth extraction. This case report discussed the antibiotic prophylaxis guidelines for different shunts patients who receive dental treatment.

並列關鍵字

Hydocephalus ； Ventriculoperiotoneal Shunt ； Antibiotic Prophylaxis