老年糖尿病患者拔牙术前血糖控制目标与预后相关性的初步分析  

Correlation analysis of pre-operative glucose control targets and tooth extraction prognosis in elderly diabetic patients

作　　者：王文英[1] 王晶[1] 王恩博[1] Wang Wenying;Wang Jing;Wang Enbo(Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology&Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院口腔颌面外科,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2021年第1期70-74,共5页Chinese Journal of Stomatology

摘　　要：目的观察老年糖尿病患者在空腹血糖>8.88 mmol/L且≤10.00 mmol/L条件下行拔牙术的安全性。方法本研究为前瞻性队列研究,纳入2018年10月至2019年10月就诊于北京大学口腔医学院·口腔医院口腔颌面外科心电监护门诊的老年糖尿病拔牙患者100例,男性53例,女性47例,年龄(75.8±8.0)岁(65~95岁)。拔牙术前空腹血糖>8.88 mmol/L且≤10.00 mmol/L的50例患者为观察组;空腹血糖≤8.88 mmol/L的50例患者为对照组,两组糖化血红蛋白(glycosylated hemoglobin,HbA1c)均≤8.5%。分别观察拔牙术后24 h、1周拔牙窝处有无疼痛、肿胀、溢脓、瘘口及全身发热,观察术后1个月拔牙窝周围组织愈合情况。采用SPSS 25.0软件对拔牙术前血糖控制目标与预后的相关性进行统计学分析。结果观察组和对照组患者术前的空腹血糖分别为(6.92±0.99)和(9.88±0.68)mmol/L,HbAlc分别为(6.76±0.83)%和(7.69±0.75)%。两组患者的年龄、性别、糖尿病病史、拔牙牙位、牙龈指数、牙齿松动度等差异均无统计学意义(P>0.05)。术后24 h,对照组与观察组拔牙窝愈合良好的患者均占94%(47/50),两组均有3例患者拔牙窝局部疼痛,但可耐受,周围组织均无红肿表现。术后1周检查创口愈合良好,术后1个月创口完全愈合。两组患者拔牙术后创口愈合状况差异无统计学意义(P>0.05)。结论拔牙术前空腹血糖≤10.00 mmol/L且HbA1c≤8.5%可作为老年糖尿病患者常规拔牙或口腔小手术的安全参考值。Objective To evaluate the prognosis of tooth extraction in elderly mellitus patients with fasting plasma glucose(FPG)>8.88 mmol/L and≤10.00 mmol/L.Methods This study was a prospective cohort study.One hundred elderly mellitus patients,53 males and 47 females,aged 65-95 years old(75.8±8.0),were recruited for tooth extraction at the ECG monitoring out-patient clinic in the Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology from Oct 2018 to Oct 2019.Fifty cases were selected into the observation group with FPG>8.88 mmol/L and≤10.00 mmol/L before tooth extraction,while the rest 50 cases were in the control group with FPG≤8.88 mmol/L.The levels of glycosylated hemoglobin(HbA1c)of patients were required to be≤8.5%before tooth extraction in both groups.Post-operative pain,swelling,pus discharge,fistula at local sockets and systemic fever were observed 24 h and 1 week after the extraction.The healing of tissues around the extraction socket was observed 1 month after operation.The correlation between blood glucose control target and the effects of socket healing before and after tooth extraction was analyzed statistically using SPSS 25.0 software.Results The pre-operative FPG levels of observation group and control group were(6.92±0.99)and(9.88±0.68)mmol/L,and HbAlc levels were(6.76±0.83)%and(7.69±0.75)%,respectively.There were no significant differences in age,gender,diabetes history,extraction position,gingival index and tooth looseness between the two groups(P>0.05).Ninety-four percent(47/50 in each group)of patients in the two groups healed well within 24 h after the extraction.There were 6 patients,3 in each of the two groups,complained tolerable post-operative pain in tooth extraction sockets.However,no redness,swelling and pus in the surrounding tissues were observed.There was no statistical difference of socket healing after the extractions between two groups(P>0.05).Conclusions The pre-operative levels of FPG≤10.00 mmol/L and HbA1c≤8.5%are reasonable

关 键 词：老年人 糖尿病 拔牙 血糖 糖化血红蛋白 

分 类 号：R587.1[医药卫生—内分泌] R782.11[医药卫生—内科学]