盐酸达克罗宁胶浆在咽反射敏感患者阻生齿拔除术中的应用  

The effectiveness of dyclonine hydrochloride mucilage in managing hypersensitive gag reflex during impac-ted wisdom tooth extraction

作　　者：李唯 张博文 李龙江[1] LI Wei;ZHANG Bowen;LI Longjiang(Department of Head and Neck Oncology,West China Hospital of Stomatology,Sichuan University,China,Chengdu 610041;Department of Comfort Care Dental Center,West China Hospital of Stomatology,Sichuan University,China,Chengdu 610041)

机构地区：[1]四川大学华西口腔医院头颈肿瘤外科,成都610041 [2]四川大学华西口腔医院舒适治疗中心

出　　处：《实用口腔医学杂志》2023年第5期642-647,共6页Journal of Practical Stomatology

摘　　要：目的:观察盐酸达克罗宁胶浆与笑气吸入镇静应用于咽反射敏感患者阻生齿拔除术的临床效果。方法:纳入需行阻生齿拔除术的咽反射敏感患者57例,根据其选择的治疗方案分为:达克罗宁组(D组)25例、笑气组(N组)32例,观察记录术前、术中的心率、血压、呼吸频率,不良反应次数,用牙科焦虑量表、视觉模拟评分法、Ramsay镇静量表、Frankle依从性量表进行评估分析。结果:D组患者术中的收缩压、心率均较术前升高(P<0.05),N组患者生命体征平稳,无明显变化。N组患者术中呼吸频率较术前明显下降(P<0.05),D组患者术前、术中的呼吸频率无统计学差异。N组的镇静评级较D组高(P<0.05),D组的疗效评估更好,不良反应发生率更低(P<0.05)。在两组的牙科焦虑患者中,N组与D组的疗效评估、不良反应发生次数无统计学差异,N组中牙科焦虑患者的镇静评级更高,治疗依从性更好,疼痛程度更低(P<0.05)。而在D组内,非牙科焦虑患者比牙科焦虑患者的治疗依从性更好,疼痛程度更低,疗效更好(P<0.05)。结论:盐酸达克罗宁胶浆能显著缓解患者在阻生齿拔除术中咽反射敏感症状。Objective:To observe the clinical effects of dyclonine hydrochloride and N_(2)O/O_(2)inhalational sedation in the impacted wisdom tooth extraction in patients with sensitive gag reflex.Methods:57 patients with impacted wisdom tooth and sensitive gag reflex were enrolled and divided into dyclonine hydrochloride group,n=25(group D)and N_(2)O/O_(2)group,n=32(group N)according to their choice of treatment.Their preoperative and intraoperative heart rate,blood pressure,respiratory rate,as well as adverse reactions were recorded.The effects were assessed and analyzed by dental anxiety scale,visual analogue scale,Ramsay sedation scale and Frankle compliance scale.Results:Comparing with preoperative vital signs,intraoperative systolic blood pressure and heart rate in the patients in Group D were elevated(P<0.05),while the vital signs of patients in group N were stable(P>0.05).The intraoperative breathing rate decreased significantly in the patients of group N(P<0.05),and there was no significant difference in the breathing rate before and during the operation in group D(P>0.05).The sedation score was higher in group N than in group D(P<0.05),but the efficacy assessment in group D was better and the incidence of gag reflex was lower(P<0.05).However,between the 2 groups,there was no significant difference in the evaluation of efficacy and the incidence of adverse reactions(P>0.05),and the sedation scores of patients with dental anxiety in group N were higher,treatment compliance was better,and the degree of pain was lower(P<0.05).Within group D,patients without-dental anxiety showed better treatment compliance,lower pain degree,and better curative effects than those with dental anxiety(P<0.05).Conclusion:Dyclonine hydrochloride can significantly control the sensitive gag reflex of the patients in impacted tooth extraction.

关 键 词：咽反射 笑气 达克罗宁 牙拔除术 

分 类 号：R782.11[医药卫生—口腔医学]