1865例儿童及青少年多生牙的临床特征与手术麻醉方式选择的相关性分析  

Analysis of the correlation between the clinical features of 1865 children and adolescents with supernumerary teeth and the selection of anesthesia methods

作　　者：张亚秋 冯彩华 梁丽荣 刘菲 吴龙 王沛娟 高珍珍 刘冰 ZHANG Yaqiu;FENG Caihua;LIANG Lirong;LIU Fei;WU Long;WANG Peijuan;GAO Zhenzhen;LIU Bing(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Disease,Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture,Department of Anesthesiology,School of Stomatology,Fourth Military Medical University,Xian 710032,China)

机构地区：[1]口颌系统重建与再生全国重点实验室、国家口腔疾病临床医学研究中心、陕西省口腔生物工程技术研究中心、第四军医大学口腔医院麻醉科,陕西西安710032

出　　处：《口腔疾病防治》2024年第12期954-962,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82101345)。

摘　　要：目的回顾分析4~18岁患者多生牙流行病学特点与手术麻醉方式选择相关影响因素,以期为儿童及青少年多生牙拔除术的麻醉方案选择提供参考依据。方法本研究为回顾性研究,已获得医院伦理委员会批准。基于临床电子病历系统及锥形束CT(cone beam CT,CBCT)资料回顾性分析2019年8月至2021年7月在第四军医大学口腔医院接受多生牙拔除术的4~18岁患者2210例,纳入标准:①年龄4~18岁;②美国麻醉医师协会(American Society of Anesthesiologists,ASA)麻醉分级Ⅰ~Ⅱ级;③具有完整的口腔及麻醉病历记录和相关影像资料。排除标准:①病历资料不完整、影像学资料不清楚者;②ASA分级在Ⅱ级以上的患者。收集患者的性别、年龄,多生牙的数量、上下颌位置、前后牙弓定位、萌出程度、生长方向,患者的预约原因、焦虑水平、配合程度、麻醉方式等相关信息并进行统计分析。结果纳入患者1865例,年龄(8.9±3.2)岁,男性患者(71.37%,1331例)多于女性(28.63%,534例)(P<0.001),性别比例为2.49:1。大多数多生牙为单发(75.97%,1417/1865),多位于上颌骨(97.2%,1812/1865)和前牙区(94.2%,1757/1865),正置位多见(77.3%,1442/1865)。多生牙萌出患者以主动就诊为主(97.67%,335/343);位于颌骨埋伏和鼻底埋伏的多生牙患者以科室转诊为主,占比94.38%(1361/1442)和90.00%(72/80)(χ^(2)=1363.24,P<0.001)。麻醉方式选择上,接受N2O镇静辅助局部麻醉或神经阻滞麻醉的比例最高,占比38.07%(710/1865),其次为接受局部麻醉,占比35.23%(657/1865),接受咪达唑仑静脉镇静辅助局部麻醉或神经阻滞麻醉以及全身麻醉的比例较少,占比分别为20.86%(389/1865)和5.84%(109/1865)。年龄13~18岁、多生牙位于下颌、后牙区、无焦虑患者接受局部麻醉的比例最高(P<0.001),而多生牙位于鼻底埋伏牙(50%)、重度焦虑(94.12%)、配合度差(98.18%)的患者接受全身麻醉的比例最高(P<0.001)。多生牙拔除术在�Objective To retrospectively analyze the epidemiological characteristics of supernumerary teeth in pa⁃tients aged 4–18 years old and the influencing factors on the selection of anesthesia methods,and to provide a refer⁃ence for the selection of anesthesia plans for children and adolescents with supernumerary teeth.Methods This study is a retrospective study approved by the Institutional Ethics Committee.Based on clinical electronic medical record sys⁃tem and cone beam CT(CBCT)data,a retrospective analysis was conducted on 2210 patients 4–18 years of age who underwent supernumerary tooth extraction at the School of Stomatology,Fourth Military Medical University from August 2019 to July 2021.Inclusion criteria:①Age 4–18 years old;and②The American Society of Anesthesiologists(ASA)classifies anesthesia into grades I⁃II;and③Have complete oral and anesthesia case records and relevant imaging data.Exclusion criteria:①Incomplete medical records or unclear imaging data;and②Patients with ASA grade II or above.Patients’gender and age,the number of supernumerary teeth,arch,location,orientation,eruption status,reason for ap⁃pointment,anxiety level,degree of cooperation,anesthesia method,and other relevant information were collected and statistically analyzed.Results A total of 1865 eligible patients were included,with an average age of(8.9±3.2)years old.There were more male patients(71.37%,1331 cases)than female patients(28.63%,534 cases)(P<0.001),with a gender ratio of 2.49:1.The majority of supernumerary teeth were single(75.97%,1417/1865),primarily located in the maxilla(97.2%,1812/1865)and the anterior dental region(94.2%,1757/1865),and in a centric position(77.3%,1442/1865).The majority of patients with erupted supernumerary teeth were active in seeking treatment(97.67%,335/343).Patients with supernumerary teeth located in the maxilla and mandible bones,as well as in the nasal floor,were mainly referred to the department for diagnosis,accounting for 94.38%(1361/1442)and 90.00%(72/80)(χ^(2)=1

关 键 词：多生牙 拔牙 麻醉 儿童 青少年 口腔科 口腔治疗 

分 类 号：R78[医药卫生—口腔医学]