老年患者拔牙的安全性探讨

Discussion on the security for tooth extraction in elderly patients

老年人在患有口腔疾患的同时,可患有多种疾病。老年人拔牙的危险因素主要是精神紧张。接受拔牙手术的恐惧、焦虑致其在术前术中都处于高度紧张状态,拔牙时间长及麻醉效果差引起血压升高和心率加快等,故消除这些危险因素是获得拔牙成功的关键。一方面取决于病人是否有足够的心理承受能力,另一方面取决于医生能否快速、准确、无痛的拔牙。而术中的任何刺激都可诱发心血管意外及其他并发症的出现。本文通过对国内外文献的归纳、总结,从严格掌握适应症、禁忌症、麻醉药物的选择、充分的术前准备、术中意外的处理以及完善的术后等多方面进行阐述,将心理治疗用于手术全过程,确保老年患者拔牙的安全性。

The elderly patients always have dental diseases with other ailments. The major risk factor for tooth extraction of old people is mental stress. The fear and nervousness for the operation always lead the elderly patients in tension state. The long time of the operation and the poor effect anesthesia always lead to the elevated blood pressure and the acceleration of heart rate. How to cope with these situation has come to be a key point for the success of tooth extraction. In normal condition, both the psychological bearing capability and the fast, accurate, and painless operation are necessary for the a successful tooth extraction. However, any stimulus during the operation may lead to cardiovascular accident and other complication. In this article, we have summarize the present papers from the indications, contraindication, drug selection, to preoperative preparation, accidental handling, and postoperative treatments. Psychological treatment has been concentrated for its important role in the security for successful tooth extraction involved with elderly patients.