全身麻醉和束缚牙科治疗对不合作患儿牙科焦虑水平的影响  

Influence of the effect of general anaesthesia and restraint during dental treatment on dental anxiety and behavior in children

作　　者：张红梅[1] 夏斌 王建红 陈小贤[1] 葛立宏 

机构地区：[1]北京大学口腔医学院·VI腔医院第一门诊部,北京100034 [2]儿童口腔科,北京100081

出　　处：《北京大学学报（医学版）》2015年第1期134-139,共6页Journal of Peking University:Health Sciences

基　　金：卫生部部属(管)医院临床学科重点项目([2010]439);首都临床特色应用研究项目(D101100050010038)资助~~

摘　　要：目的：评价不合作患儿在全身麻醉下或束缚下进行牙科治疗后,其牙科畏惧水平及就诊行为的变化。方法：全身麻醉组为全身麻醉下进行牙科治疗的4~6岁重度牙科畏惧症患儿31例,束缚组为在性别、年龄、治疗前焦虑水平、口腔内龋坏情况与全身麻醉组严格匹配的在束缚下进行牙科治疗的患儿31例。应用MCDASf（face version of the Modified Child Dental Anxiety Scale,MCDASf）中文版量表评价两组患儿治疗前、治疗后和2~3周复诊时主观畏惧水平的变化,同时评价两组患儿治疗时和复诊时的临床就诊行为变化。结果：全身麻醉组治疗后、复诊前MCDASf中文版量表平均得分较治疗前下降,差异均有统计学意义。束缚组治疗后、复诊前MCDASf中文版量表平均得分均较治疗前略上升,但差异无统计学意义。两组间MCDASf中文版量表治疗前、后变化的差异有统计学意义。全身麻醉组患儿经全身麻醉治疗后复诊时的临床就诊行为表现较治疗时的临床就诊行为表现有所改善,两者差异有统计学意义（P〈0.01）。束缚组治疗后复诊时的临床行为表现较束缚治疗时的临床就诊行为有所改善,差异有统计学意义（P〈0.01）。结论：全身麻醉下牙科治疗能够缓解牙科畏惧症患儿就诊中的焦虑、恐惧情绪,提高患儿治疗的合作性,改善其短期复诊的就诊行为。束缚下牙科治疗后患儿的牙科畏惧水平略有增高,但差异无统计学意义,短期复诊时的就诊行为表现有所改善。Objective： To compare the level of dental anxiety and dental behavior between dental fear children with dental treatment under general anaesthesia（ GA） and those under restraint. Methods： The GA group included 31 dental fear children aged 4- 6-year-old who received dental treatment under the GA. The restraint group included 31 dental fear children aged 4- 6-year-old who received dental treatment under the restraint. Age,gender,parent＇s education level,decayed-missing-filled tooth（ dmft）and face version of the Modified Child Dental Anxiety Scale（ MCDASf） score before treatment were matched between the two groups. The Chinese version of MCDASfwas used to evaluate the level of dental anxiety in each child before treatment,right after treatment and before examination at recall visit 2- 3weeks after treatment. And the Chinese version of Venham Clinical Anxiety and Cooperative Behavior Scale was used to evaluate children＇s dental behavior in each child before treatment and before examination at recall visit 2- 3 weeks after treatment. Results： The average scores of MCDASfin GA group right after treatment and before recall were lower than that before treatment. The difference was statistically significant（ P〈 0.05）. Furthermore,the average score of MCDASfbefore recall was lower than those after treatment,and the difference was statistically significant（ P〈 0.05）. The average scores of MCDASfin restraint group right after treatment and 2- 3 weeks after treatment were higher than those before treatment,but the difference was not statistically significant（ P〈 0.05）. Children＇s dental behavior was significantly improved at recall visit in both groups（ P 〈0. 01）. Conclusion： Dental fear could be reduced by treatment under GA. The children＇s dental behavior was improved after GA. Restraint did not result in the significant elevation of dental anxiety level,but dental behavior was improved after restraint during the short-term recall.

关 键 词：牙科治疗焦虑 麻醉药 全身 约束 身体的 儿童 

分 类 号：R788[医药卫生—口腔医学]