笑气吸入镇静在微创拔除下颌埋伏阻生第三磨牙中的临床研究  

Clinical research of inhaled nitrous oxide by conscious-sedation in embedded and impacted mandibular third molars extraction with minimally invasive

作　　者：孙辉[1] 陈志方 黄艳青 SUN Hui;CHEN Zhi-fang;HUANG Yan-qing(Hefei oral clinical college,anhui medical university·ral maxillofacial surgery,hefei oral hospital,anhui hefei 230001,China;Hefei clinical college of stomatology,anhui medical university·epartment of stomatology,hefei oral hospital,anhui hefei 230001,China)

机构地区：[1]安徽医科大学合肥口腔临床学院.合肥市口腔医院口腔颌面外科,安徽合肥230001 [2]安徽医科大学合肥口腔临床学院.合肥市口腔医院口腔综合科,安徽合肥230001

出　　处：《全科口腔医学电子杂志》2018年第19期3-6,共4页Electronic Journal of General Stomatology

基　　金：合肥市自主创新政策"借转补"资助项目(YW201512010004)

摘　　要：目的探讨笑气吸入镇静在微创拔除下颌埋伏阻生第三磨牙的临床应用效果。方法选取我院拔除下颌埋伏阻生第三磨牙的患者60例,随机分为两组,实验组在笑气吸入镇静系统下微创拔牙,对照组采用微创拔牙。通过心电监护仪记录两组患者局麻前、局麻时、拔牙中、拔牙后5min和拔牙后10min的血压、心率及呼吸频率的变化。拔牙结束后调查两组患者对整个拔牙过程的主观感受,根据VAS评定患者疼痛程度并记录。结果实验组在整个拔牙过程中血压、心率及呼吸频率变化小,生命体征平稳,在局麻时和拔牙中与对照组相比有显著地差异,差异有统计学意义(P<0.05);局麻时、拔牙中和拔牙后5min的VAS评分实验组均低于对照组,差异有统计学意义(P<0.05);拔牙后10 min的VAS评分实验组与对照无显著差异,差异无统计学意义(P>0.05)。结论笑气吸入镇静能够有效的减轻注射麻药及拔牙过程的疼痛刺激,缓解患者拔牙的紧张、恐惧等焦虑情绪,并且联合微创技术提高了患者拔除下颌埋伏阻生第三磨牙的舒适度,值得临床广泛推广。Objective To explore the clinical effect of nitrous oxide inhalation in impacted mandibular third molars extraction with minimally invasive.Methods The extraction of mandibular impacted tooth of 60 patients in our hospital were randomly divided into two groups,minimally invasive extraction under nitrous oxide inhalation sedation system in the experimental group and conventional minimally invasive extraction in the control group.The changes of blood pressure,heart rate and respiratory rate were recorded by ECG monitor in two groups before and during local anaesthesia and during extraction as well as 5 minutes and 10 minutes after extraction.Subjective feelings were investigated in two for groups of patients after the whole process of extraction,and the pain level was analyzed and recorded with visual analogue scale(VAS).Results The experimental group,with stable vital signs,showed much less changes in blood pressure and heart rate,and respiratory rate during the whole process of extraction.Significant difference was found before local anesthesia and during extraction between two groups(P<0.05).Compared with the control group,VAS score was lower in the experimental group during local anesthesia,and during and after extraction for 5 minutes(P<0.05).Significant difference of VAS score was not found 10 minutes after extraction between two groups(P>0.05).Conclusion Nitrous oxide inhalation by conscious-sedation is worthy of being widely applied in clinic,because it can effectively reduce pain stimulus in local anesthesia injection and tooth extraction,relieve the anxiety of tooth extraction,and improve comfort in patients combined with minimally invasive technique of tooth extraction.

关 键 词：笑气吸入镇静 微创拔牙 阻生第三磨牙 心电监护 

分 类 号：R782.054[医药卫生—口腔医学]