老年高血压病患者牙科焦虑症对血压及心率的影响  

Effect of dental anxiety on blood pressure and heart rate in elderly patients with hypertension

作　　者：刘海燕[1] 蔡文玮[1] 陈谊[1] 胡萍[1] 成静[1] 陈朝婷[1] 盛净[1] 陆平[1] 刘淑萍[1] Liu Haiyan;Cai Wenwei;Chen Yi;Hu Ping;Cheng Jing;Chen Chaoting;Sheng Jing;Lu Ping;Liu Shuping(Department of Geriatrics,Ninth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai,200011,P.R.China)

机构地区：[1]上海交通大学医学院附属第九人民医院老年科,上海200011

出　　处：《老年医学与保健》2020年第4期546-549,558,共5页Geriatrics & Health Care

摘　　要：目的观察老年高血压病患者拔牙手术期间牙科焦虑症(DA)对患者血压和心率的影响。方法2018年3月—2019年5月,简单随机抽样法抽取上海交通大学医学院附属第九人民医院口腔外科心血管拔牙门诊行拔牙术的老年高血压病患者371例。采用改良的牙科焦虑量表(DAS)评估患者的焦虑水平,监测拔牙术中患者的血压和心率。结果371例患者DAS总分4~19分,平均(8.39±3.15)分,DAS≥13分者43例(11.6%)。患者拔牙前、麻醉后和拔牙后的收缩压(F=51.167,P<0.01)、舒张压(F=54.014,P<0.01)及心率(F=48.530,P<0.01)差异均有统计学意义。不同焦虑水平的患者在拔牙前、麻醉后和拔牙后的收缩压、舒张压差异均有统计学意义(P<0.05)。患者DAS评分与收缩压增幅正相关,存在线性回归关系(b=0.539,P<0.01)。结论老年高血压病患者拔牙过程中的血压与DAS评分在一定程度上存在相关性,DA越严重,拔牙术中收缩压、舒张压越高,但心率升高不明显。Objective To observe the effect of dental anxiety(DA)on blood pressure and heart rate in elderly patients with hypertension during tooth extraction surgery.Methods From March 2018 to May 2019,371 elderly patients with hypertensionwho underwent tooth extraction surgery in the outpatient department of oral surgery of our hospitalwere selected by simple random sampling.The anxiety level of these patients was evaluated by the modified dental anxiety scale(DAS).Their blood pressure and heart rate were monitored during tooth extraction surgery.Results The DAS score of 371 patients ranged from 4 to 19 points,with an average of(8.39±3.15)points.43 patients(11.6%)gotDAS≥13 points.The differences in systolic blood pressure(F=51.167,P<0.01),diastolic blood pressure(F=54.014,P<0.01)and heart rate(F=48.530,P<0.01)were all statistically significant before tooth extraction,after anesthesia and after tooth extraction.The differences of systolic and diastolic blood pressure before tooth extraction,after anesthesia and after tooth extraction in patients with different anxiety levels were statistically significant(P<0.05).The DAS score was positively correlated with the increase of systolic blood pressure,and there was a linear regression relationship(b=0.539,P<0.01).Conclusion There is a certain degree of correlation between blood pressure and DAS score during tooth extraction in elderly patients with hypertension.The more severe the DA,the higher the systolic and diastolic blood pressure during tooth extraction,but the increase in heart rate is not obvious.

关 键 词：老年 牙科焦虑症 高血压 心率 血压 

分 类 号：R544.1[医药卫生—心血管疾病] R781.05[医药卫生—内科学]