笑气吸入辅助拔除儿童埋伏多生牙的临床应用

摘要/Abstract

摘要： 目的：分析笑气吸入辅助拔除儿童埋伏多生牙的临床疗效，为临床提供参考依据。方法：选取2016年1月-2018年2月于我院就诊的114例需拔除埋伏多生牙的患儿，随机分组分别进行笑气吸入辅助拔牙和常规拔牙，观察患儿状态及治疗效果。结果：大多数患儿能够顺利完成拔牙术，未出现麻醉意外。笑气吸入组患儿拔牙时能根据指令作出正确反应并能保持呼吸道通畅，98.25%患儿可以顺利完成治疗，有效缩短操作时间（P<0.05），依从性评分标尺Frankle评分更低（P<0.05），患儿更配合，无恶心呕吐，拔牙后意识清晰，正常活动未受影响，未发生过度镇静和术后留院观察现象。结论：笑气吸入辅助拔除儿童埋伏多生牙疗效确切，并且可明显降低患儿临床焦虑情绪，缩短治疗时间，降低需全麻治疗的概率，提高治疗完成率及患者满意度，值得临床上推广应用。

关键词: 笑气吸入, 儿童埋伏多生牙, 焦虑, 临床疗效

Abstract: Objective To analyze the clinical effect of nitrous oxide inhalation on extraction of embedded supernumerary teeth, and to provide reference for the subsequent clinical research. Methods a total of 114 children who were admitted to our hospital from January 2016 to February 2018 were selected for extraction of embedded supernumerary teeth. They were randomly divided into two groups: tooth extraction assisted by nitrous oxide inhalation and tooth extraction routine. Then the condition of the children and curative effects were observed. Results Most of the children were able to complete tooth extraction without any anesthesia accident. Nitrous oxide inhalation group could respond correctly according to the instruction and keep respiratory tract unobstructed, shorten the operation time (P < 0.05), and lower Frankle score (P<0.05). Among them, 98.25% children could complete treatment, and have no nausea or vomiting, have clear consciousness after tooth extraction, normal activity unaffected, no excessive sedation or postoperative hospital phenomenon. Conclusion Nitrous oxide inhalation assisted extraction of embedded supernumerary teeth in children is effective, and can significantly reduce clinical anxiety, shorten treatment time, reduce the probability of general anesthesia treatment and improve treatment completion rate and patient satisfaction, which is worthy of clinical application.

Key words: nitrous oxide inhalation, the child embedded supernumerary teeth, anxiety, clinical curative effect

中图分类号:

R782.11

刘靖王万根吴永正. 笑气吸入辅助拔除儿童埋伏多生牙的临床应用[J]. 口腔医学, 2020, 40(9): 829-832.

参考文献

[1]朱志军, 万林忠, 朱启红.上颌前部埋伏多生牙的临床分析[J].口腔颌面外科杂志, 2001, 11(1):85-86
[2]张震康，樊明文，傅民魁.现代口腔医学[M].北京:科学出版社，2002:822-825.
[3]Chikkala J, Chandrabhatla SK, Vanga NR.Variation in levels of anxiety to dental treatment treatment among non-orphan and orphan children live under different systems[J].J Nat Sci Biol Med, 2015, 6(1):S13-S16
[4]关明, 王恩博, 刘宇, 等.咪达唑仑静脉注射对儿童埋伏多生牙拔除术中镇静效果的临床评价[J].北京大学学报医学版, 2012, 44(1):120-124
[5]刘鹍鹏.笑气吸入对口腔科手术患者的麻醉镇痛效果评价[J].西部医学, 2014, 26(11):1509-1511
[6]张志娟, 黄丽佳, 肖丽娟.笑气吸入镇静技术应用于口腔种植术的护理[J].护士进修杂志, 2014, 29(15):1398-1399
[7]刘冰, 朱伟, 闫维, 等.笑气吸入对阻生齿拔除术局麻药镇疼效果的影响[J].实用口腔医学杂志, 2013, 29(01):80-82
[8]王立新, 倪耀丰, 孙玉华.笑气吸入辅助拔除阻生齿对减轻牙科焦虑症的临床效果[J].牙体牙髓牙周病学杂志, 2014, 24(4):238-241
[9]钟恬, 胡道勇.笑气氧气吸入镇静技术及其在儿童口腔临床中的应用[J].华西口腔医学杂志, 2014, 32(1):101-104
[10]葛鑫，周志斐，张百泽，等.笑气氧气镇静在牙科畏惧症患儿口腔治疗中的应用研究[J].临床口腔医学杂志, 2018, 34(7):419-422
[11]董正谋, 蒋和田, 刘鲁川, 等.笑气吸入清醒镇静法在阻生牙拔除术中的临床观察[J].第三军医大学学报, 2011, 33(10):1071-1074
[12]Al-Khotani A, Bello LA, Christidis N.Effects of audiovisual distraction on children's behaviour during dental treatment: a randomized controlled clinical trial[J].Acta Odontol Scand, 2016, 74(6):494-501
[13]Dionigi A, Gremigni P.A combined intervention of art therapy and clown visits to reduce preoperative anxiety in children[J].J Clin Nurs, 2017, 26(5-6):632-640
[14]曾素琴, 蔡明雪.笑气吸入法在儿童牙科畏惧症中的应用[J].现代医院, 2009, 9(09):50-51
[15]Wilson S.A survey of the American academy of pediatric dentistry membership: nitrous oxide and sedation[J].Pediatr Dent, 1996, 18(4):287-293
[16] Galeotti A, Garret Bernardin A, D' Antò V, et al.Inhalation conscious sedation with nitrous oxide and oxygen as alternative to general anesthesia in precooperative, fearful, and disabled pediatric dental patients: A large survey on 688 working Sessions[J]. Biomed Res Int, 2016, 2016: 7289310.
[17]Musani IE, Chandan NV.A comparion of the sedative effect of oral versus nasal midazolam combined with nitrous oxide in uncooperative children[J].Eur Arch Paediatr Dent, 2015, 16(5):417-424
[18]Salem K, Khoshrang H, Kousha M, et al.Efficacy and safety of orally administered intravenous midazolam versus a commercially prepared syrup[J].Iran J Pediatr, 2015, 25(3):e494-
[19]陈诚, 周艳.笑气吸入镇静镇痛技术在口腔种植手术中的临床效果研究[J].南通大学学报医学版, 2019, 39(1):43-45
[20]中华口腔医学会.口腔治疗中笑气-氧气吸入镇静技术应用操作指南试行[J].中华口腔医学杂志, 2010, 45(11):645-647
[21]Shepherd AR, Hill FJ.Orthodontic extractions: a comparative study of inhalation sedation and general anaesthesia[J].Br Dent J, 2000, 188(6):329-331