儿童龋病充填中两种预防牙科畏惧症方法的成本效果分析

Cost effective analysis of two methods on their preventing dental fear during caries filling treatments in children

目的 :从卫生经济学的角度对治前教育和局部麻醉两种方法在龋病充填治疗中预防儿童牙科畏惧症 (DF)的效果进行评价。方法 :下颌第一恒磨牙牙合面患龋的 15 0名小学生 ,随机分为 3组 ,每组 5 0例(男、女各 2 5 ) ,第一组 (治前教育 ) ,提前 1h接受有关龋病教育 ;第二组 (局部麻醉 )提前 15min进行局麻 ;第三组 (空白对照 )不做针对DF的干预。三组均接受常规的充填治疗。比较各组的DF发生率并进行卫生经济学评价。结果 :三组DF的发生率分别为 10 % ,18%和 4 2 % ,差别显著 (χ2 =15 .5 0 31,P =0 .0 0 0 4 ) ,三组的人均成本投入分别为 83.99元 ,87.0 9元和 87.76元 ;为减少 1例DF ,第一、二组分别比第三组少投入 11.80元和 2 .79元 ,为减少 1例充填物损坏 ,第一、二组分别比第三组少投入 31.4 0元和 11.17元。结论 :儿童龋病充填治疗中 ,用治前教育法和局部麻醉两种预防DF的方法都有效 。

AIM:To determine the effects, in economic aspect of preventing dental fear(DF) by preoperative education or local anesthesia during the process of tooth filling. METHODS: All of 150 cases suffered from occlusal caries on the mandibular first molars. They were divided into 3 equal groups: Group 1(pre operative education) was showed with educational video tape on caries about 1h preoperatively. Group 2(local anesthesia) recieved 1.8mL of 2% lidocaine for local anesthesia. Group 3(blank) was used as control. After that, all subjects accepted same filling treatment as usual. During that process, DF of each case was evaluated blindly based on Venham's clinical ratings of anxiety and cooperation. After operation the side effect and results from reexamination and economical analysis were studied. RESULTS: Significant differences of DF rate were found between these groups (10%,18% and 42%,χ 2=15.5031, P =0.0004). Cost minimization analysis showed that costs of each case in 3 groups were 83.99 yuan,87.09 yuan and 87.76 yuan respectively. Cost effective analysis for decrease 1 case of DF in group 1 and group 2, it was 11.8 yuan and 2.79 yuan respectively less than that of the group 3 . For decrease 1 case of filling defeat, in group 1 and group 2 the cost is 31.40 yuan and 11.17 yuan less than that of the group 3 respectively. CONCLUSION: Preoperative education and local anesthesia were both effective in preventing DF, but the former is much better.