Page 70 - 根管治療的美麗與哀愁 (柒部曲)

˸ʃ໮ቛ০Ⴠݓ๞̈࣬φ୞͋ஷ༸dʃषʾϤࣛԨӚϞڌତ̈ชաՑ़೨ٙˀᏐf༹Ա
ృ EOM ࠅჯd஼Ӊҁϓ࿁ 21 ࣬၍ٙ૶௴ၾࡌҖfʘܝd኿֛ɓ˕፿ܓቇ຅ٙ˴ᇭ০d

΋ᅲࣛ܆И࣬၍ʕݬՑ࣬φݬٙ၍ഢஷ༸fᎇܝdίᜑฆᗝ՘пɨd˸ڗݛՒਚ࿁၍ኣ
ॎฦஈЪ૶ଣdኋ̙ঐܱৰၵழ኉ሯഐ࿴eձಞवٙف׌ଡ଼ᔌf຾әݹܝd೹ฆє৻᜖
ഢdਗ਼୑ٙॷ০φ၌ب 3% ᕐः˥ (hydrogen peroxide H O )dʱй׳ՑՇਉ၍ኣॎฦஈd
2
2
Ԩಃݸɹ̮ٙ˫࣬մࣙଡ଼ᔌଫЪऊݭf್ܝdਗ਼਒ϓʃ෯ٙ׼ᇭऎၧ (gelfoam)dɓ෯
෯પ৔Ց၍ኣॎฦਜ˫̮࣬ఖd݅຅ᛖֵіڝᒻАeΝࣛɰЪ˟АdԨ˲̂຅܈ღd๟
௪וટ௟И MTA ࿁၍ኣॎฦஈٙ੗ྼ෬෦fᎇܝd˸ฆ᐀ٙ৻ଋಗଢІ၍ഢʕd቗௓
ί MTA ٙ෬໾ɪdΎ˸ᕐᄴ܆෬ҿd੗ྼ෬໾᜖ഢ၊ݸf՝ɨዖͤღdשᙲ X ΈᏨൖd
ᆽႩ 21 ڐeჃːՇਉ၍ኣΪ̮іϗהிϓٙॎฦdʊ຾աՑѼቇή෬෦ ( ྡ 79H)fਗ਼

طᐕආܓѓൡઃ٫͎ɿ࠼ɛjͦۃʊ຾ਗ਼ 21 ၍ഢஷ༸ʕٙᕸϥeאաՑชݑٙଡ଼ᔌd
ஹΝί˫̮࣬௅ٙ೯فଡ଼ᔌኋ̙ঐ૶ৰદfΝࣛd࿁Շஈ၍ኣٙॎฦdɰʊ຾̙͜˸Ⴐ
ኬ৶͛ϓٙ͛ي޴࢙ҿ (MTA) ʚ˸෬໾ࡌూfಂܙ˚ܝ̴̙˸ᔷʷϓ၍ኣٙɓ௅΅d
΍ΝЪމ࣬၍ஷ༸ชݑછ၍ٙ܈ᇱdԨ˲

ঐ՘пႰኬ˫̮࣬ఖ˫৶ሯᄴٙᄣ͛eޟ
Їঐ੄Ҟ஺ήႰኬ኉ᅻ৶ٙᓹΥూࡡfᔊ ྡ79H ཞ඄d຾
҅௅௦ቑܝd࿏ֵ
ఊήႭdϤՍԱ຾᜕޶Ըd21 ঐ੄஗वИ
૶ৰ21၍༸୞͋ݬ
ٙዚึ޴຅ɽfΫ̘ܝdʥცᘱᚃ؂͜Ҥ ٙಞπଡ଼ᔌdԨீ
͛९dʔཀ͜ඎ̙˸ಯϓɓ˂Շϣdν؈ ཀ၍ኣॎฦஈܱৰ
˫̮࣬௅ٙ೯فଡ଼
זԂɿًرཀ׵ᘌࠠdΎಯϓӊ˂ɓϣd ᔌi΋˸৵Ըᇭ᜗
ٜЇ؂ҁ዆ࡈմಂٙ͜ඎ (Clindamycin ᅲࣛ෬෦࣬φݬஷ
150mg 1# bid x7days; so 14# in total, at ༸ܝd࿁Շஈ၍ኣ
ٙॎݸ˸׼ᇭऎၧ
least 1# qd until finished if diarrhea too Ъᛖֵ܈ღdΎ͜

serious)fҎૐɓ඄ܝΫൢd˸ک࿁ 21 ၍ MTA෬໾ࡌూ
ഢஷ༸Ύϣ૶ଣd್ܝʚ˸ᇘ੗෬̂f
ཞ඄͎ɿՑൢdʃषʾڌͪjɪϣطᐕΫ̘᎘ۃ˂d˫኉ᙂ੻Ϟᓃദദٙdʔཀவ

఻˂ఱᙂ੻λܘεəi̥݊؂͜ᖹيʘܝd዆ࡈɛᒔ݊ʔബ؂eழၧၧٙd౤ʔৎۊd
ତίӊ˂ҷϓ̥؂͜ɓᒶfΎϣΣઃ٫
ྡ79I ɖ˂ܝઃ٫๟
͎ɿ࠼ɛ੶ሜd؂͜வࡈᖹيٙ̀ࠅ׌d ࣛՑൢd׬ܤ࿁؂͜
߰݊ৣΥඵܝ؂͜d࿁໑ߞՐዧٙˀᏐ Ҥ͛९הˏৎٙ໖ᓧ

ఱึʃɓᓃdሗਕ̀਺ܵ؂ҁ዆ࡈմಂ ձΌԒழࢮೌɢܘዄ
ːiΎϣ࿁ઃ٫͎ɿ
ٙኒඎ ( ྡ 79I)fટഹίӚϞഗʚ҅௅௦ ੶ሜdԱषرᆽϞ؂
ቑɨd࿁ 21 τɪዖͤღd୅ৰᑗࣛ෬໾ ͜ᖹي՘Νطᐕٙ̀
ࠅdሗਕ̀਺ܵ؂ҁ
يdආՑ᜖ഢ၊ݸܝd຾೹ฆәݹd׵
዆ࡈմಂٙኒඎiΝ
ᜑฆᗝ՘пɨd˸࣬၍ઞ০ᆽႩɪΫ෬ ࣛdʃषʾڌͪjɪ
໾ࡌూՇஈ၍ኣॎݸٙ MTAdոЗձ೷ ϣطᐕΫ̘᎘ۃ˂d
˫ ኉ ᙂ ੻ Ϟ ᓃ ദ ദ
ʷٙઋر޴຅ଣซd຾ॷ০ᆽ֛၍ഢӚ ٙdʔཀவ఻˂ఱᙂ
Ϟਉᗙသဍܝd΋Դ͜Όዢܓϣಣაඒ ੻λܘεə

58 ʔᓙіϗอٝdܵᚃ৛ᔳ᜕ᗇd޴ڦԒ᜗ଡ଼ᔌٙᆑঐ