150例低危老年高血压患者拔牙安全性的临床分析

Extraction of Teeth in Low Risk High Blood Pressure Geriatric Patients

目的:通过监测低危高血压患者拔牙过程中各时间点的血压波动,分析高血压患者拔牙的安全性。方法:选择患有单纯性高血压(符合《中国高血压病防治指南》规定的低危标准),且需实施简单拔牙术的150例患者。其中100例手工测量术前10 min、麻醉后即刻、拔牙后即刻、拔牙后30 min共4个时间点的血压和心率,另50例在心电监护仪的监测下拔牙。分析高血压患者拔牙过程中的血压波动情况。结果:在严密监控下,150例研究对象中,有3例在麻醉后出现收缩压高于180 mmHg或舒张压高于100 mmHg,终止拔牙术,转内科治疗至血压稳定后择期拔除。其余病例术中、术后血压和心率波动均在正常范围,未发生心血管意外或创口出血、感染等并发症。结论:通过规范选择适应证,完善的术前检查,术中轻柔操作,并注意密切监测血压、心率变化,社区医院对大部分低危的高血压患者拔牙是安全的。

Objective： To evaluate the safety condition of tooth extraction in low risk high blood pressure aged patients.Methods： 150 aged hypertension patients underwent tooth extraction were retrospectively reviewed.Group A（n=100）,patients＇ blood pressure and cardiac rhythm were detected manually at 10 min before operation,immediately after local anaesthesia,tooth extraction completed and 30 min after extraction.Group B（n= 50）,patients＇ extraction procedures were monitored through electrocardiogram（EKG）.Results： The blood pressure and heart rates of all 150 cases during tooth extraction and postoperation were in the normal level.No case of accident,postoperative hemorrhage or infection was found.Conclusion： Cardiovascular diseases which may become important factors in the result of oral surgical procedures in geriatric patients should be carefully considered.Then the patients with hypertension would be safe when tooth extraction was performed in community hospitals.