微创拔牙技术与凿骨劈冠法拔除残根残冠对患者疼痛及应激状况的影响  

The influence of minimally invasive tooth extraction technique and bone chiseling method to remove residual root and crown on patients'pain and stress

作　　者：李方[1] 王涛[1] 苏智勇[1] 苏佳楠 刘剑英[1] 赵纪源 随丽娜[1] Li Fang;Wang Tao;Su Zhiyong;Su Jiannan;Liu Jianying;Zhao Jiyuan;Sui Lina(Zhengzhou People's Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州人民医院,河南郑州450000

出　　处：《临床心身疾病杂志》2021年第2期46-50,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨微创拔牙技术与凿骨劈冠法拔除残根残冠对患者疼痛及应激水平的影响。方法将473例残根残冠患者按治疗方案不同分为微创组(285例)及常规组(188例)。常规组采用凿骨劈冠法治疗,微创组采取微创拔牙技术治疗。比较两组手术时间、术中失血量、拔牙窝完整性评分、并发症发生率、治疗满意度,手术前后龈沟液炎性介质(前列腺素E2、髓过氧化酶、细胞间粘附分子-1、五正聚蛋白-3)、应激指标(丙二醛、活性氧、过氧化物酶体增殖因子活化受体γ)、疼痛介质(半乳糖胺、P物质、降钙素基因相关肽)变化情况。结果微创组手术时间显著短于常规组(P<0.01),术中失血量显著少于常规组(P<0.01),拔牙窝完整性评分显著低于常规组(P<0.01)。术后第1 d、第3 d末微创组龈沟液炎性介质(前列腺素E2、髓过氧化酶、细胞间粘附分子-1、五正聚蛋白-3)、应激指标(丙二醛、活性氧、过氧化物酶体增殖因子活化受体γ)及疼痛介质(半乳糖胺、P物质、降钙素基因相关肽)水平均显著低于常规组(P<0.01)。微创组并发症总发生率显著低于常规组(P<0.01),治疗总满意率显著高于常规组(P<0.01)。结论微创拔牙技术治疗残根残冠手术时间短,术中损伤小,并发症少,能显著减轻术后局部炎症及应激反应,减少疼痛介质分泌,提高患者满意度,优于凿骨劈冠法。Objective To explore the effect of minimally invasive tooth extraction technique and bone chiseling method to remove residual root and crown on patients'pain and stress.Methods A total of 473 patients with residual root and crown were divided into minimally invasive group(285 cases)and conventional group(188 cases)according to different treatment plans.The conventional group was treated with bone chiseling method,and the minimally invasive group was treated with minimally invasive tooth extraction technique.The operation time,intraoperative blood loss,tooth extraction socket integrity score,complication rate,treatment satisfaction,and changes in inflammatory mediators of gingival crevicular fluid(prostaglandin E2,myeloperoxidase,intercellular adhesion molecular-1,Pentraxin-3),stress indicators(multi-dimentional analysis,reactive oxygen species,peroxisome proliferator-activated receptorγ),and pain media(galactosamine,P substance,calcitonin gene-related peptide)were compared between the two groups.Results The operation time of the minimally invasive group was shorter than that of the conventional group(P<0.01).The blood loss during operation was lower than that of the conventional group(P<0.01).The tooth extraction socket integrity score was lower than that of the conventional group(P<0.05).The level of inflammatory mediators in the gingival crevicular fluid(prostaglandin E2,myeloperoxidase,intercellular adhesion molecular-1,Pentraxin-3),stress indicators(multi-dimentional analysis,reactive oxygen species,peroxisome proliferator-activated receptorγ),and pain media(galactosamine,P substance,calcitonin gene-related peptide)of the minimally invasive group was significantly lower than that of the conventional group on the 1st and 3rd day after operation(P<0.01).The total incidence of complications in the minimally invasive group was significantly lower than that in the conventional group(P<0.01),and the total satisfaction rate of treatment was significantly higher than that in the conventional group(P<0.01).Conclusio

关 键 词：残根残冠 微创拔牙技术 凿骨劈冠法 疼痛 应激反应 炎性介质 并发症 

分 类 号：R782.11[医药卫生—口腔医学]