口腔种植手术并发晕厥的危险因素分析

Analyses of risk factors of oral implant surgery complicated by syncope

目的研究分析种植手术临床因素与晕厥发生率之间的相关关系。方法回顾性分析本院2008年9月至2011年9月收治的778例行口腔种植手术患者的临床资料，对其中17例并发晕厥患者的性别、年龄、麻醉方式、手术方法、手术部位、手术时间进行logistic回归分析。结果Logistic回归分析显示：性别（女性比男性）优势比（OR）=0．699，95％可信区间（95％CI）为（0．126，1．874），P=0．477；年龄（〈40岁比≥40岁）OR=3．122，95％CI（1．103，8．834），P=0．032；麻醉方式（浸润＋阻滞麻醉比单纯浸润麻醉）OR=3．380，95％CI（1．087，10．512），P=0．035；手术方法（植骨＋种植术比单纯种植术）OR=5．427，95％CI（1．140，25．835），P=0．034；手术部位（前牙区比后牙区）0R=0．783，95％CI（0．299，2．051），P=0．619；手术时间（≥2h比〈2h）OR=2．841，95％CI（1．055，7．649），P=0．039：其中年龄（〈40岁）、麻醉方式（浸润＋阻滞麻醉）、手术方法（植骨＋种植术）、手术时间（≥2h）是晕厥发生的危险因素。结论在口腔种植手术中，年龄〈40岁、行浸润＋阻滞麻醉、行植骨＋种植术、手术时间≥2h者术中发生晕厥的危险性增高，值得临床高度重视。

Objective To analyze the correlation between the clinical factors of implant surgery and the incidence of syncope. Methods Routine oral implant surgery was performed on 778 cases admitted in this hospital from September 2008 to September 2011, among them 17 cases developed syncope, their clinical factors including gender, age, method of anesthesia, surgical techniques, surgical site, surgical time were retrospectively analyzed, and logistic regression analyses were carried out. Results The results of logistic regression analyses ： gender （women vs. men） advantage odd ratio （OR） = 0.699, 95% confidence interval （95%CI） 0.126 to 1.874, P = 0.477 ; age （ 〈40 years vs. old I〉40 years） OR = 3.122, 95%CI 1.103 to 8.834, P = 0.032 ; mothod of anesthesia （infiltration ＋ block anesthesia vs. simple infiltration anesthesia） OR = 3.380,95%CI 1.087 to 10.512, P = 0.035 ; surgical methods （grafting ＋ implantation vs. simple implant） OR = 5.427, 95%CI 1.140 to 25.835, P = 0.034; surgical site （the anterior tooth region vs. the posterior tooth region） OR = 0.783, 95%CI 0.299 to 2.05 , P = 0.619 ; operation time （ 〉t2 hours vs. 〈2 hours）OR = 2.841,95%CI 1.055 to 7.649, P = 0.039. The analyses showed that age 〈 40 years, block anesthesia, bone graft ＋ implantation, operation time ≥2 hours were the risk factors to develop syncope. Conclusions High attention should be paid on patients undertaking oral implant surgeries whose ages are 〈40 years old, using block anesthesia, bone graft ＋ implantation techniques and the operative time ≥2 hours, because under these conditions, the risk to develop syncope is increased.