牙拔除术患者并发晕厥38例的原因分析及防治措施

Retrospective analysis of 38 syncope cases who underwent teeth extraction

目的回顾分析我科2006年1月—2008年12月牙拔除术患者并发晕厥的原因及采取的防治措施。方法采取详细询问调查的方法,了解患者牙拔除术前的精神状况、心理状态、既往拔牙史及全身情况等,手术中仔细观察患者,做好全面记录。结果晕厥的发生与患者的年龄有关,20-40岁是牙拔除术并发晕厥的高危人群,初次拔牙、拔牙前的心理准备不充分、紧张恐惧及惧怕疼痛对晕厥反应的发生影响较大。结论牙拔除术前详细询问病史,严格掌握牙拔除术适应证,认真做好诊前3min交流,安慰疏导患者,消除患者紧张恐惧心理;牙拔除术中密切观察患者,发现异常情况,医护紧密配合采取相应的处理措施,对预防晕厥发生、保障患者安全及手术顺利进行至关重要。

Objective To analyse the causes and preventive measures by retrospective study of 38 cases of syncope due to extraction of teeth in the Dental Department of Oral and Maxillofacial Surgery of Jiangsu Provincial Stomatological Hospital from 2006.1 to 2008.12. Methods Methods of detailed inquisition and investigation were used to comprehend the mental state,past history of teeth extraction,general health state and so on. Patients were carefully observed and their records were kept during the operation. Results Syncope was related to the ages of patients. Extraction of teeth accompanied with syncope mostly occurred in patients aged from 20 to 40 years old. Primary teeth extraction,inadequate psychological preparation,tension and fear of pain were related to the occurrence of dental treatment syncope. Conclusion To avoid the extraction of teeth accompanied with syncope and guarantee the safety of patient,great attention must be paid to the detailed case history,indication of extractionpsychology,consultation,pain relief and the easing of anxiety.