STA无痛麻醉仪在心脑血管患者牙拔除术中的应用  

Application of STA painless anesthesia instrument in tooth extraction for patients with cardiovascular and cerebrovascular diseases

作　　者：刘潇[1] 闫明 冯晓伟[1] 李向军[1] 张扬[1] 张旭东[1] LIU Xiao;YAN Ming;FENG Xiaowei;LI Xiangjun;ZHANG Yang;ZHANG Xudong(Department of Oral and Maxillofacial Surgery,Department of Oral Radiology,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017)

机构地区：[1]河北医科大学口腔医学院·口腔医院河北省口腔医学重点实验室河北省口腔疾病临床医学研究中心,石家庄050017 [2]河北省眼科医院口腔颌面外科

出　　处：《现代口腔医学杂志》2021年第3期149-153,共5页Journal of Modern Stomatology

基　　金：河北省卫健委青年科技课题项目(20191080);河北省政府资助专科能力建设和带头人培养项目(361029)。

摘　　要：目的通过监测心脑血管病患者在拔牙治疗中生理指标和心理指标的变化,评估比较STA无痛麻醉和传统的局部麻醉两种方法在麻醉过程中和手术过程中减轻患者疼痛的效果。方法选择河北医科大学口腔医院口腔颌面外科门诊2018年7月~2020年6月就诊的需行牙拔除术心脑血管患者80例进行随机对照试验。两种麻醉器械包括STA(试验组)和传统卡局式注射器(简称:传统注射器)(对照组)。生理指标包括收缩压(systolic blood pressure,SBP)、舒张压(diastolicblood pressure,DBP)、心率(heart rate,HR);心理指标通过Wong-Baker FACES疼痛量表、Frankl治疗依从性量表(the franklbehavior rating scale,Frankl)和Houpt行为量表(the houpt behavior rating scale,Houpt)以及患者满意度评价,对数据进行统计分析。结果 (1)两种麻醉器械在麻醉过程中对患者生理指标的影响:术中无痛STA局部麻醉与传统局部浸润麻醉相比,血压,心率升高的少,更容易稳定在安全范围内(P<0.01,P<0.05)。(2)两种麻醉方式在麻醉过程中对患者心理指标的影响:与对照组相比,试验组的Frankl和Houpt值高,两组差异有统计学意义(P<0.05)。在麻醉过程中,STA组患者在Wong-Baker FACES疼痛量表上感受到的疼痛较少,有统计学意义(P<0.001)。(3)患者术后对两种麻醉器械反应评价的分析显示,STA患者的治疗体验明显较好,且更倾向于今后采用相同的注射方法(P<0.05)。结论在麻醉和拔牙过程中,与传统的麻醉技术相比,STA无痛麻醉仪的使用可以有效降低心脑血管患者麻醉过程中的疼痛程度,以及降低患有心脑血管等系统性疾病的老年患者并发症的发生,从而使患者达到无痛、舒适以及安全的治疗效果。Objective To evaluate the effectiveness of comparing two anesthesia methods, STA painless anesthesia and traditional local anesthesia, in reducing patients’ pain during anesthesia and during surgery by monitoring and recording the changes in physiological and psychological parameters of cardiovascular and cerebrovascular patients during tooth extraction treatment. Methods A randomized controlled trial was conducted to select 80 cardiovascular and cerebrovascular patients who visited the Oral and Maxillofacial Surgery Clinic of the Hebei Medical University Stomatology Hospital from July 2018 to June 2020 for tooth extractions. Two anesthesia devices included STA(test group) and traditional cassette syringe(abbreviated as: conventional syringe)(control group). The physiological parameters included Systolic blood pressure(SBP), Diastolic blood pressure(DBP), Heart rate(HR);psychological parameters included Wong-Baker FACES pain scale, Frankl’s treatment compliance, and the Systolic blood pressure(SBP), Diastolic blood pressure(DBP), and Heart rate(HR). The Franklbehavior rating scale(Frankl) and the Houpt behavior rating scale(Houpt), as well as the patient satisfaction scale, were analyzed using paired and unpaired t-tests. Results(1) The effect of two types of anesthesia devices on patients’ physiological parameters during anesthesia: intraoperative painless STA was less likely to increase blood pressure and heart rate and more likely to stabilize within a safe range compared with local infiltration anesthesia(P<0.01, P<0.05).(2)The effect of two types of anesthesia devices on patients’ psychological parameters during anesthesia: compared with the control group, the Frankl and the Houpt behavioral rating scale in the experimental group were analyzed by the paired and unpaired t-tests. Houpt values were high, and the difference between the two groups was statistically significant(P<0.05). During treatment,STA patients experienced less pain on the WongBaker FACES pain scale, which was statistically significa

关 键 词：STA无痛麻醉 牙拔除术 老年心脑血管患者 疼痛体验 患者满意度 

分 类 号：K782.1[历史地理—历史学]