儿童全麻与单纯束缚下牙齿治疗的短期对比研究  

Comparison of the children＆#39;s oral health habits and oral-health-related quality of life following treatment under dental general anesthesia and passive restraint

作　　者：肖雨萌[1] 夏斌[1] 马文利[1] 张笋[1] 王建红[1] 葛立宏[1] 

机构地区：[1]北京大学口腔医学院·口腔医院儿童口腔科,100081

出　　处：《中华口腔医学杂志》2014年第9期525-529,共5页Chinese Journal of Stomatology

基　　金：卫生部部属（管）医院2010-2012年度临床学科重点项目;北京市科学技术委员会首都临床特色应用研究项目（D101100050010038）志谢北京大学第一医院医学统计研究所李雪迎研究员对本文数据统计工作的帮助和指导

摘　　要：目的 观察对比儿童全麻与单纯束缚下牙齿治疗术后患者的口腔卫生习惯、口腔健康相关生活质量及短期治疗效果的异同,为临床医师选择两种行为管理方式提供参考.方法 收集2012年4月至2013年1月北京大学口腔医学院＆#183;口腔医院儿童口腔科2～4岁接受全麻下牙齿治疗的患者28例（全麻组）及单纯束缚下治疗的患者35例（束缚组）,对两组病例进行非随机对照研究.收集患者的基本信息,记录初诊时患龋及口腔卫生状况,由家长填写口腔健康习惯调查问卷和幼儿口腔健康相关生活质量量表.在全麻或单纯束缚下完成预定的牙齿治疗（如充填术、根管治疗术、预成冠修复、牙齿拔除术等）,所有病例半年复查时均记录口腔卫生和患龋状况,检查充填体是否脱落,并由家长再次填写以上问卷和量表.结果 初诊时全麻组患者年龄[（3.1±0.6）岁]显著大于束缚组[（2.8±0.4）岁]（P=0.017）,全麻组龋失补牙数（13.1±4.1）亦显著大于束缚组（7.9±3.4）（P＜0.001）.半年复查时全麻组术后的口腔健康相关生活质量（疼痛症状、口腔疾病对生活、心理和家庭的影响等）均较术前明显改善（P＜0.05）,束缚组疼痛症状评分较术前显著降低（P＜0.05）.束缚组和全麻组患者复查时新发龋和（或）再发龋率（分别为37.1％、39.3％）、继发龋率（分别为4.1％、2.3％）和充填体脱落率（分别为1.5％、2.7％）差异均无统计学意义（P＞0.05）.结论 两种行为管理方式各有优势,短期内的治疗效果无明显差异;儿童接受全麻下牙齿治疗有利于提高其口腔健康相关生活质量,术后医师应帮助家长及患者养成良好的口腔卫生习惯.Objective To compare the children＇s oral health habits and oral-health-related quality of life following treatment under dental general anesthesia（DGA） and passive restraint（PR）.Methods In the Department of Pediatric Dentistry,Peking University School and Hospital of Stomatology,twenty eight 2 to 4-year-old patients treated under DGA and thirty five treated under PR were collected in this non-randomized controlled trial.The general information including age and decayed,missed and filled teeth（dmft）,dental plaque index was recorded preoperatively.Two questionnaires,questionnaire of oral health habits and early childhood oral health impact scale（ECOHIS） were completed by parents before and 6 months after treatment （including restoration,root canal treatment,stainless steel crown,tooth extraction,etc.）.Six months after treatment,dental plaque index and restoration were reexamined.Results The patients were significantly elder in DGA group[（3.1 ±0.6） years old,P〈0.05],and the mean dmft was significantly higher（13.1 ±4.1,P〈0.001） in DGA group.The postoperative dietary habits and brushing habits significantly improved in PR group,but not in the DGA group.However,according to the results of ECOHIS,the occurrence of pain,the impacts of patients on daily life,psychology and family due to the oral diseases significantly decreased in DGA group（P〈0.05）,while in PR group,only the occurrence of pain reduced（P〈0.05）.No statistical difference was found between the two groups in new caries or recurrent caries（PR group：37.1%,DGA group：39.3%）,secondary caries（PR group：4.1%,DGA group：2.3%）,and failure of the restoration（PR group：1.5%,DGA group：2.7%）.Conclusions Each behavior management technique has advantages and drawbacks,and no statistical differences were found in the treatment results between the two techniques.

关 键 词：麻醉 全身 儿童口腔医学 对比研究 身体束缚 

分 类 号：R782.054[医药卫生—口腔医学]