笑气联合咪达唑仑在儿童埋伏多生牙拔除术中的镇静效果  

Sedative efficacy of nitrous oxide combined with midazolam in extraction of impacted supernumerary teeth in children

作　　者：束煌[1] 王骥[1] 陈婵婵[1] 邝亦元[1] 丁桂聪[1] SHU Huang;WANG Ji;CHEN Chanchan;KUANG Yiyuan;DING Guicong(Department of Stomatology,Shenzhen Children's Hospital, Shenzhen 518026, China)

机构地区：[1]深圳市儿童医院口腔科,广东深圳518026

出　　处：《口腔疾病防治》2019年第5期304-308,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省自然科学基金项目(2017A030310595)

摘　　要：目的了解笑气吸入联合口服咪达唑仑镇静状态下对儿童埋伏多生牙拔除术的镇静效果及安全性,为儿童阻生牙无痛拔除的麻醉方式选择提供参考。方法拟行上颌埋伏多生牙拔除术的5～10岁患者60例,随机分为3组,每组20例。笑气组:术前采用笑气吸入镇静;咪达唑仑组:术前采用咪达唑仑口服镇静;联合组:术前采用笑气吸入联合咪达唑仑口服镇静。在局麻拔牙术前先行镇静,术后评价各组患儿的Ramsay量表效果、Houpt行为量表评分及不良反应发生率。结果联合组Ramsay量表效果评分(2.75±0.55)高于笑气组(2.30±0.47)和咪达唑仑组(2.40±0.50),差异具有统计学意义(P <0.05)。联合组Houpt行为量表评分(5.25±0.64)高于笑气组(4.70±0.73)和咪达唑仑组(4.80±0.69),差异具有统计学意义(P <0.05)。联合组不良反应发生率(5%)低于笑气组(10%)和咪达唑仑组(10%),3组差异无统计学意义(χ~2=0.436,P=0.804)。结论笑气吸入联合口服咪达唑仑镇静用于儿童埋伏多生牙拔除术中,可明显提高患儿镇静效果和治疗效果,不良反应发生率低,是一种安全有效的镇静方法。Objective To study the sedative efficacy and safety of nitrous oxide(N2 O) inhalation combined with oral midazolam in children with impacted supernumerary teeth for extraction under sedation and to provide a reference for the selection of anesthetic methods for children undergoing impacted teeth extraction. Methods Sixty patients aged5-10 years with maxillary impacted supernumerary teeth were randomly divided into three groups, with 20 in each group, as follows: the N2 O group: N2 O inhalation sedation before the operation;the midazolam group: oral midazolam sedation before the operation;the combination group: N2 O inhalation combined with oral midazolam sedation before the operation. Sedation was performed before extraction under local anesthesia. The Ramsay sedation effect, Houpt behavioral score and incidence of adverse reactions were evaluated after the operation. Results The Ramsay sedation scale score was significantly higher in the combination group(2.75 ± 0.55) than in the N2 O group(2.30 ± 0.47) and the midazolam group(2.40 ± 0.50)(P < 0.05). Similarly, the Houpt behavioral rating scale score was significantly higher in the combination group(5.25 ± 0.64) than in the N2 O group(4.70 ± 0.73) and the midazolam group(4.80 ± 0.69)(P < 0.05).The adverse reaction rate was lower in the combination group(5%) than in the N2 O group(10%) and the midazolam group(10%), but the difference was not significant(χ^2=0.436, P=0.804). Conclusion N2 O inhalation combined with oral midazolam sedation in the extraction of impacted supernumerary teeth in children can significantly improve the sedative and therapeutic efficacy and is a safe and effective sedation method.

关 键 词：镇静 笑气 咪达唑仑 儿童 牙科畏惧症 埋伏多生牙 牙拔除术 无痛技术 

分 类 号：R78[医药卫生—口腔医学]