老年心脑血管病患者监护拔牙的临床观察

Clinical observation on monitoring for tooth extraction in the heart-cerebrovascular disease in the elderly.

目的探讨老年心血管疾病患者拔牙时的安全性问题与影响因素。方法随机将685例心脑血管病患者分为老年组与非老年组(A、B组)。A组为>60岁老年患者586例,B组为60岁以下患者99例,共拔牙1 027人次。拔牙术中采用连续心电、血压监护,测定两组患者麻醉前、拔牙术中及拔牙术后的血压、心率值,所得数据进行统计学处理(μ检验)。结果除手术中两组收缩压差异无显著性外(P>0.05),其余各组对应项目差异均有显著性(P均<0.05)。结论高龄不是造成老年患者拔牙意外的主要原因。重要的是良好的麻醉效果、熟练的拔牙技术、稳定患者的情绪、适应症的选择以及必要的心电血压监护。

Objective Study safety problem and influence factor during tooth extraction in the heart-cerebrovascular disease in the elderly. Methods Six hundred and eighty five patients were divided randonmly into A and B groups. Group A was 589 cases of over 60 years old, group B was 99 cases of below 60 years old, totally teeth extraction in l 027 peoples. The continous monitoring of eIetroeardiogram （ECG） , blood pressure （BP） and heart rate （HR） were performed during tooth extraction. The BP and HR were determined before anaesthesia, during tooth extraction and after tooth extraction, the data proceeded to statistical analysis. Results The systolic pressure change difference have no statistical significance（P〉0.05） except during 2 groups tooth extraction, other items difference have to statistical significance （ P〈0.05 ）. Conclusion The aging is not the main reason of tooth extraction accidental. The key points are ： good anaesthesia with cautious technique of tooth extraction, keep- ing emotion stability, restrict the choice of indication and necessary monitoring of ECG, BP, HR.