镇静镇痛干预在心脑血管心电监护下种植牙植入手术中的应用价值

Application value of sedation or analgesic intervention for cardiovascular and cerebrovascular diseases patients in dental implant surgery with ECG

目的:探讨镇静镇痛干预在心脑血管心电监护下种植牙植入手术中的应用价值。方法:选择2012年3月至2013年3月本院所收治的51例采用种植牙植入术修复牙列缺损,并患有心脑血管疾病患者。随机将患者分为对照组、镇静组和镇痛组3组,每组17例。对照组患者采用常规心理安慰干预;镇静组患者给予笑气吸入镇静干预;镇痛组患者给予适当药物治疗。比较分析3组患者种植牙植入手术后12个月临床效果、患者术后满意度以及手术前后血压及心率变化情况。结果:与对照组相比,镇静组和镇痛组患者12个月后种植牙植入手术成功率均明显提升,均可达到94.12%,术后在稳固性、咀嚼能力、美观程度、舒适程度以及总体满意度等方面均明显提高,局麻后、术中及术后收缩压和舒张压均明显降低,局麻后、术中心率均明显降低,组间比较差异均具有统计学意义(P<0.05)。讨论:对于心脑血管疾病患者,心电监护下种植牙手术联合应用镇静或镇痛干预不仅能够提高种植牙临床效果,还能有效避免患者血压及心率的波动,从而为患者种植牙手术的安全性提供了保障。

Objective： To study the application value of sedation or analgesic intervention for the patients with cardiovascular and cerebrovascular disease in dental implant surgery under ECG. Methods： From March 2012 to March 2013,51 dental implant surgery patients combined with cardiovascular and cerebrovascular diseases were selected in our hospital. The patients were divided into control group, sedation group and analgesia group randomly,17 cases in each group. The patients in control group were treated with conventional psychological comfort intervention. The patients in sedation group were treated with nitrous oxide inhalation sedation intervention.The patients in analgesia group were treated with appropriate medication. The clinical effects of dental implant surgery after planting 12-month,satisfaction and postoperative changes in blood pressure and heart rate of the patients in three groups were compared and analyzed. Results： Compared with control group,the dental implant success rate of 12 months after implant surgery was improved significantly in sedation group and analgesia group,up to 94. 12%. The postoperative stability, ability to chew aspects, aesthetic appearance, comfort and overall satisfaction were improved significantly. The systolic and diastolic blood pressure of local anesthesia,surgery and post-operation were decreased significantly. The heart rate of local anesthesia and surgery were decreased significantly,there were significant difference（ P 〈0. 05）. Conclusion： For patients with cardiovascular and cerebrovascular diseases,dental implant surgery under ECG combined with sedation or analgesia intervention,is not only to improve dental implant clinical effect,and can avoid fluctuations in blood pressure and heart rate effectively. Thus it provides security protection for patients for dental implant surgery.