同步根测预备法结合超声荡洗在糖尿病患者根管治疗中的临床疗效评价

doi:10.13591/j.cnki.kqyx.2023.08.008

摘要/Abstract

摘要：

目的观察分析同步根测预备法结合超声荡洗在糖尿病患者根管治疗中的临床效果。方法选取2020年10月—2021年9月于合肥市口腔医院综合科就诊,需行根管治疗且为2型糖尿病的患者80例,采用随机法分为研究组及对照组,每组各40例。其中研究组患者使用VDW Gold Reciproc根管马达(在根管预备同时控制工作长度)结合超声荡洗进行根管治疗,对照组采用常规根管马达结合注射器冲洗进行根管治疗。治疗前及根充术后一周使用IMMULITE1000西门子化学发光分析仪对患者血清中白细胞介素(interleukin,IL)-6、IL-8、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平进行比较;比较两组患者治疗前及治疗后6、12、24、48、72 h的疼痛视觉模拟评分(visual analogue scale,VAS);并评价术后一年两组根管治疗总有效率。结果两组患者治疗完成后一周,IL-6、IL-8、TNF-α等炎性因子水平均较治疗前降低,且研究组明显低于对照组(P<0.05);在术后不同时间点,研究组VAS均低于对照组,但仅在术后6、12 h差异有统计学意义(P<0.05);研究组患者治疗总有效率为95%,对照组为90%,但两组间无显著性差异(P>0.05)。结论同步根测预备法结合超声荡洗可以有效降低糖尿病患者术后疼痛并控制炎症,可以临床推广。

关键词: 根管预备, 超声荡洗, 术后疼痛

Abstract:

Objective To observe and analyze the clinical effect of simultaneous root canal preparation combined with ultrasonic washing in root canal treatment of diabetic patients. Methods A total of 80 patients with type 2 diabetes requiring root canal treatment from October 2020 to September 2021 in the General Department of Hefei Stomatology Hospital were selected and randomly divided into study group and control group, with 40 cases in each group. Patients in the study group received root canal treatment with VDW Gold Reciproc root canal motor (controlling the working length during root canal preparation) combined with ultrasonic washing, while the control group received conventional root canal motor combined with syringe irrigation for root canal therapy. Serum interleukin (IL) -6 (IL-6), IL-8, and tumor necrosis factor-α (TNF-α) levels were compared before and 1 week after treatment by IMMULITE1000 Siemens chemiluminescence analyzer. Visual analogue scale (VAS) of pain before treatment and 6, 12, 24, 48 and 72 h after treatment were compared between the two groups. The total effective rate of root canal treatment was evaluated one year after operation. Results One week after completion of treatment, the levels of IL-6, IL-8 and TNF-α were decreased in both groups, and the study group was significantly lower than the control group (P<0.05). The VAS in the study group was lower than that in the control group at different time points after operation, but the difference was statistically significant only at 6 and 12 h after operation (P<0.05). The total effective rate was 95% in the study group and 90% in the control group, which was higher in the study group than in the control group without significant difference (P>0.05). Conclusion Simultaneous root canal preparation combined with ultrasonic washing can effectively reduce postoperative pain and control inflammation in patients with diabetes, which is recommended in clinical practice.

Key words: root canal preparation, ultrasonic washing, postoperative pain

中图分类号:

R781.3

谢玉庆, 张扬, 汪磊. 同步根测预备法结合超声荡洗在糖尿病患者根管治疗中的临床疗效评价[J]. 口腔医学, 2023, 43(8): 711-716.

XIE Yuqing, ZHANG Yang, WANG Lei. Clinical efficacy evaluation of simultaneous root canal preparation combined with ultrasonic washing in root canal treatment of diabetic patients[J]. Stomatology, 2023, 43(8): 711-716.

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组别	IL-6/(pg/mL)		P	IL-8/(pg/mL)		P	TNF-α/(pg/mL)		P
组别	治疗前	治疗后	P	治疗前	治疗后	P	治疗前	治疗后	P
研究组	4.82±1.72	2.12±0.28	0.01	15.64±4.57	8.53±4.49	0.00	6.24±1.63	2.19±1.17	0.00
对照组	4.65±1.16	3.24±0.14	0.02	16.19±3.60	10.48±3.10	0.00	6.12±2.01	4.45±1.09	0.01
t	1.89	18.01		0.21	8.51		0.16	4.41
P	0.13	0.00		0.84	0.00		0.87	0.00

时间	研究组		对照组		χ²	P
时间	无疼痛	疼痛	无疼痛	疼痛	χ²	P
术后6 h	15(37.50)	25(62.50)	7(17.50)	33(82.50)	4.01	0.04
术后12 h	19(47.50)	21(52.50)	9(22.50)	31(77.50)	5.49	0.02
术后24 h	23(57.50)	17(42.50)	16(40.00)	24(60.00)	2.45	0.12
术后48 h	29(72.50)	11(27.50)	28(70.00)	12(30.00)	0.06	0.80
术后72 h	36(90.00)	4(10.00)	34(85.00)	6(15.00)	0.46	0.50

时间	研究组	对照组	P
术前	45.93±24.46	45.50±21.67	0.98
术后6 h	36.83±19.70	40.35±19.28	0.00
术后12 h	24.62±16.58	37.73±17.64	0.00
术后24 h	20.07±21.05	25.89±14.81	0.86
术后48 h	11.31±10.87	12.55±12.26	0.90
术后72 h	2.61±1.80	4.58±2.06	0.29

疗效	研究组	对照组
治愈	32(80.00)	28(70.00)
显效	6(15.00)	8(20.00)
无效	2(5.00)	4(10.00)
χ²	0.72
P	0.40