不同高血压分级患者急性牙髓炎开髓治疗的风险评估  

Risk assessment of different grades of hypertension during the treatment of patients with acute pulpitis

作　　者：陈红涛[1] 王文英[1] 王津[1] 梁亚平[1] 王小婷[1] 侯光敏[1] 姬爱平[1] 

机构地区：[1]北京大学口腔医学院.口腔医院急诊科,北京100081

出　　处：《北京大学学报（医学版）》2016年第1期89-93,共5页Journal of Peking University:Health Sciences

摘　　要：目的:评估不同高血压分级患者治疗急性牙髓炎过程中的生命体征变化和影响因素,以获得风险预防措施。方法:纳入2014年2月至2015年2月间就诊于北京大学口腔医院急诊科的不同高血压分级的急性牙髓炎患者90例,收集患者的全身健康状况、口腔治疗情况、生命体征的变化等信息,根据高血压患者的心脑血管风险评估分型,把纳入研究的患者分为牙髓炎治疗的低危组、中危组和高危组各30例。结果:(1)与术前相比,高危组术中收缩压升高、舒张压升高、心率增快的比例都在80%以上(分别为90%、80%、100%),中危组和低危组各项指标升高的比例明显低于高危组,差异有统计学意义(P<0.01);同时,高危组超过1/4(26.7%)的患者收缩压增幅大于20 mm Hg(1 mm Hg=0.133 k Pa),2/5的患者舒张压增幅大于10 mm Hg,与中危组和低危组相比差异有统计学意义(P<0.05)。(2)与术前相比,高危组术中收缩压和舒张压变化的最大峰值均增高,收缩压增高(18.0±1.5)mm Hg,舒张压增高(8.0±1.7)mm Hg,心率变化均值也增加了(7.0±0.3)次/min,而低危组和中危组这两项指标均下降;高危组有6例在治疗过程中出现心电图改变,低危组和中危组则无明显改变。(3)术前初评、术后终评的风险评估对比发现,中危组患者在术后被评价为中等危险的有23例,6例被评价为低等危险,1例为高等危险(风险评级增加);高危组术后被评价为高等危险的有20例,7例被评价为极高危险,3例为中等危险(风险评级降低)。结论:口腔治疗对于高血压患者来说是非常安全的,但危险因素、靶器官受损及并发症也会增加高血压患者在治疗过程中出现心血管意外的风险,因此应该采取一定措施来规避风险。Objective： To evaluate the vital signs changes, influence factors in different grades of hy- pertension patients during the treatment of acute pulpitis, in order to obtain the risk prevention measures. Methods： In this study, 90 different grades of hypertension patients with acute pulpitis were recruited from February 2014 to February 2015 in the Department of Oral Emergency, Peking University School and Hospital of Stomatology. The information about the patients＇ general health, oral treatment, life signs of change information was collected. Patients were divided into high risk group, middle risk group, and low risk group （30 patients for each group）. Results： （ 1 ） Compared with the preoperative, systolic blood pressure （90%） , diastolic blood pressure （80%） , heart rate increase （100%） were increased in the high risk group. The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group （P 〈0.01 ）. At the same time, the systolic blood pressure of 1/ 4 （26.7%） patients in high risk group increased more than 20 mmHg （1 mmHg =0. 133 kPa）, and the diastolic blood pressure of 2/5 patients in high risk group increased more than 10 mmHg, the difference was statistically significant compared with the other two groups （P 〈 0.05 ）. （2） Compared with the pre- operative, the average increase of the maximum peak were increased [ systolic blood pressure （ 18.0 ± 1.5） mmHg, diastolic blood pressure （8.0 ± 1.7） mmHg] , the mean of heart rate changes [ （7.0± 0.3 ） beats per minute ] was also increased in the high risk group, while these two indicators were de- creased in the low risk group and the middle risk group. The electrocardiogram （ECG） was changed in 6 cases during the treatment in the high risk group. No significantly changed were observed in the low risk group and the middle risk group. （3） Compared the risk assessment in preoperative with that in postoperative, in the middle risk g

关 键 词：高血压 牙髓炎 危险性评估 

分 类 号：R781.31[医药卫生—口腔医学]