糖尿病患者拔牙创口愈合影响因素及处置方法的改进  

Influencing factors of the wound treatment and cicatrization for diabetic exodontia and the improvement of disposal measures

作　　者：杨治忠 李梅花 祝新梅 滕亮 豆志强 董根喜[2] 

机构地区：[1]甘肃省武威市第二人民医院口腔科,甘肃武威733000 [2]兰州大学口腔医学院,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2014年第2期76-80,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：武威市科技支撑计划项目(ww120314)

摘　　要：目的临床观察糖尿病患者拔牙术后影响创口愈合的因素,以期能为这部分患者找到简单、安全、有效的口腔局部治疗措施,促进拔牙创口的愈合。方法将口腔门诊需要拔牙的糖尿病患者80人次随机分为治疗组和对照组,两组患者均按照传统的方法进行局部麻醉及术前口腔洁治,对照组处理:创腔常规刮治,创口复位,明胶海绵药物创口内填塞,由患者咬棉垫30 min压迫止血,术前1 d及术后3 d联合使用抗生素预防感染;治疗组处理:拔牙创腔内及牙周袋内壁炎性肉芽组织刮治,创腔内使用纯碘仿粉剂,由医生用棉球蘸碘仿粉压迫创口止血直到血凝块形成,替代患者咬合棉垫压迫止血,术前、术后不全身使用止痛药、止血药及抗生素等。比较两组患者拔牙创口出血量、出血时间、局麻过后的创口疼痛程度、创口初步愈合时间、患者因拔牙花费的时间和医疗费用。结果治疗组患者拔牙后创口出血量较对照组减少了46.4%,出血时间明显缩短,麻醉过后的创口疼痛程度按照视觉模拟评分法标准评分,平均分值为对照组的44.4%。全程拔牙所花费的时间缩短至对照组的17.9%,所产生的医疗费用减少了约3/4。结论通过提高对影响糖尿病患者拔牙创口愈合因素的认识,改进创口处置方法,使糖尿病患者能够更加简单、安全、有效的接受牙拔除术。Objective To observe the influencing factors of the exodontia wound treatment and cicatrization in diabetes patients clinically so that an easier,safer and more effective method of oral cure measure can be found to promote the wound healing.Methods Eighty diabetes patients demanding exodontia were selected and divided into experimental group and control group randomly and they were treated with conventional anesthesia,preoperative oral cavity cleaning and disinfection sterilize.The experimental ones received compression of cotton ball with iodoform powder for oppression hemostasis instead of conventional therapy disposed on control ones that stuffed with gelatin sponge drugs inside wound for hemostasis.Preoperation and 3 days after operation,combined antibiotics were used to prevent infection,which,as well as painkillers and hemostatic medicine,were not systemically used on experimental populations.Then quantum of the wound bleeding,bleeding time,pain degree of the wound after anaesthesia,course and incipient cicatrization,time and fee-for-service paid by the patients for the operation were observed comparatively.Results Compared to the control ones,the wound bleeding amount for experimental patients decreased by 46.4%after tooth extraction,along with obviously shortened bleeding time.And their average score was only 44.4%in the control group according to the VAS score standard.The total time decreased to 17.9%and the expenditure to 3/4,compared with those of the control population.Conclusion By elevating the cognition on the influencing factors of the exodontia wound cicatrization in diabetes patients,and improving the methods of the wound treatments,the diabetic exodontia can be performed easily,as well as safely and effectively.

关 键 词：糖尿病患者 拔牙术 创口处置 

分 类 号：R781.6[医药卫生—口腔医学]