改良三点注射麻醉在下颌阻生第三磨牙拔除术中的临床可行性研究  

Clinical feasibility study on modified three-point injection anesthesia in the extraction of mandibular third molars

作　　者：聂小汉 陈栋 吕娇 张雪梅[1] 张啸飞[1] 罗顺云 NIE Xiao-han;CHEN Dong;LV Jiao;ZHANG Xue-mei;ZHANG Xiao-fei;LUO Shun-yun(Department of Stomatology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Stomatology,Beijing Chaoyang Maternal and Child Care Hospital,Beijing 100021,China.)

机构地区：[1]清华大学附属北京清华长庚医院口腔科,清华大学临床医学院,北京102218 [2]北京市朝阳区妇幼保健医院口腔科,北京100021

出　　处：《临床口腔医学杂志》2022年第3期160-163,共4页Journal of Clinical Stomatology

摘　　要：目的:评价改良三点注射法在下颌阻生第三磨牙拔除术中麻醉的有效性和安全性。方法:共63例志愿者加入临床试验,使用左右半口设计,随机采用传统下牙槽神经阻滞麻醉和改良三点注射法进行麻醉,并拔除下颌阻生第三磨牙。比较两组麻醉起效时间和手术时间,以及麻醉注射时、手术中及手术后疼痛的视觉模拟评分。结果:改良三点注射法和传统下牙槽神经阻滞麻醉有效率分别为98.41%和96.83%;在传统下牙槽神经阻滞麻醉组,5例(7.93%)出现回抽见血,3例(4.76%)出现注射时剧烈疼痛,改良三点注射组未出现;两者均未出现血肿及干槽症。传统下牙槽神经阻滞麻醉手术时间与改良三点注射组无统计学差异,麻醉起效时间与改良三点注射组有统计学差异(P<0.05)。疼痛视觉模拟评分,麻醉注射时,改良三点注射组明显低于传统下牙槽神经阻滞麻醉(P<0.05);手术中和手术后两者均无统计学差异。结论:在下颌阻生第三磨牙拔除术中,改良三点注射法成功率高,并发症少,是一种有效的麻醉方法。Objective:To evaluate the anesthetic effect and safety of modified three-point injection anesthesia in the extraction of impacted mandibular third molars.Methods:A split mouth study was designed.The bilateral impacted mandibular third molar of 63 participants were divided into conventional inferior alveolar nerve block anesthesia and modified three-point injection anesthesia randomly with mandibular third molar extracted.Clinical factors including effecting time point,operation time,visual analogue scale(VAS)of pain were evaluated.Results:The anesthetic success rate was 98.41%in modified three-point injection group and 96.83%in conventional inferior alveolar nerve block group.There were 5 patients(7.93%)experienced blood withdrawal,and 3 patients(4.76%)experienced severe pain during injection in the conventional inferior alveolar nerve block anesthesia group,without occurrence in the modified three-point injection.There was no hematoma or dry socket in either group.There was no significant difference in the operation time between two gruops.There was significant difference in the effecting time point(P<0.05).For the visual analogue scale of pain during injection,the modified three-point injection was significantly lower than the traditional inferior alveolar nerve block,with statistical difference(P<0.05).There was no significant difference during operation and post operation between the two groups respectively.Conclusion:The modified three-point injection anesthesia has a high success rate and fewer complications,and is an effective anesthesia method in the extraction of impacted mandibular third molars.

关 键 词：改良三点注射麻醉 下牙槽神经阻滞麻醉 疼痛视觉模拟评分 阻生第三磨牙拔除 

分 类 号：R782[医药卫生—口腔医学]