下颌复杂阻生智齿拔除手术并发症的药物控制  

Medication of the sequelae after extraction of lower impacted wisdom teeth

作　　者：周宏志[1] 胡开进[1] 秦瑞峰[1] 孔亮[1] 侯锐[1] 

机构地区：[1]西安第四军医大学口腔医学院口腔颌面外科,710032

出　　处：《实用口腔医学杂志》2009年第5期706-709,共4页Journal of Practical Stomatology

摘　　要：目的:探索下颌复杂阻生智齿拔除手术并发症的简便有效药物控制方案。方法:选取双侧下颌第三磨牙复杂阻生且类型相似病例90例,分2次拔除。首次手术局麻药物中加入地塞米松5 mg,术后口服抗生素3 d;第2次手术时分组,首次出现中度肿胀或疼痛等并发症者改为术前口服一次抗生素,首次轻度反应者不再使用地塞米松。比较2次手术后并发症情况。结果:术后并发症程度与拔牙难度、手术时间和药物应用方案相关,术前应用抗生素可以更为有效的控制并发症,放弃使用地塞米松后,出现较多肿胀和张口受限情况。结论:术前联合应用抗生素和地塞米松可以有效控制复杂阻生牙术后并发症,药物应用方案应根据术前难度评估确定。Objective：To establish an effective medication protocol for control of the sequelae after lower impacted wisdom teeth extraction.Methods：A total of 90 patients with similar impacted third molar in both sides of mandible were involved.Teeth were extracted by two operations.Dexamethason was added into local anaesthetic in the first operation and antibiotic was used orally in the after three days.The next time,patients were divided into two groups.Those who had gotten medium edema/pain or other sequelae after the first tooth extraction were instructed to take antibiotic before this operation.The others with light reaction accepted normal anaesthetic without dexamethason.Reactions to the changes of the medication methods were compared.Results：Severity of the postoperative sequelae associated significantly with the difficulty of teeth extraction,actual operation time and medication protocol.Pre-operation application of antibiotic could better control the sequelae.Without dexamethason,edema and trismus occurred more frequently.Conclusion：Combination of antibiotics and dexamethason before complicated teeth extraction can effectively depress the postoperative negative reactions.The medication scheme should be decided according to the difficulty assessment before tooth extraction.

关 键 词：下颌阻生智齿 牙拔除术 术后并发症 药物治疗 

分 类 号：R782.11[医药卫生—口腔医学]