糖尿病与非糖尿病患者根管治疗术后临床疗效的对比研究

A Comparative Study of Clinical Effect of Root Canal Therapy for Patients with and Without Diabetes

目的探讨糖尿病与非糖尿病患者根管治疗术后临床疗效,旨在提高临床诊疗水平。方法整群选取该院2013年1月—2014年1月所收治根管治疗患者140例,根管治疗患者包括牙髓炎患者和根尖周炎患者,分别探讨两种疾病合并糖尿病时的临床表现,随机分为牙髓炎组(73例)和根尖周炎组(67例),均采用一次性根管治疗,对比两组患者中糖尿病患者和非糖尿病患者临床疗效及术后疼痛情况。结果牙髓炎组糖尿病患者、非糖尿病患者疼痛发生率差异无统计学意义(P>0.05);根尖周炎组患者糖尿病患者疼痛发生率为26.7%,显著高于非糖尿病患者的5.4%,差异有统计学意义(P<0.05);牙髓炎组糖尿病患者、非糖尿病患者总有效率差异无统计学意义(P>0.05);根尖周炎组患者糖尿病患者总有效率为20.0%,显著低于非糖尿病患者的67.6%,差异有统计学意义(P<0.05)。结论牙髓炎患者由于感染程度较轻、病变范围有限,所以糖尿病与非糖尿病患者之间临床表现无显著差异;根尖周炎患者由于感染更严重,且病变范围较大,其糖尿病患者临床表现较非糖尿病患者差,临床治疗此类患者时应注重血糖控制和合并症状处理。

Objective To discuss the clinical curative effect of root canal therapy for patients with and without diabetes so as to improve the level of diagnosis and treatment. Methods 140 patients with pulpitis or periapical periodontitis who underwent singlevisit root canal therapy in our hospital during January 2013 and January 2014 were randomized into pulpitis group（n=73） and periapical periodontitis group（n=67）. The clinical manifestations of the two diseases in combination with diabetes were discussed re-spectively. The clinical effects and postoperative pain of the patients with and without diabetes in the two groups were compared.Results In the pulpitis group, there was no statistically significant difference between the postoperative pain of the patients with and without diabetes（P〉0.05）; in the periapical periodontitis group, the rate of postoperative pain of the patients with diabetes,26.7%, was obviously higher than that of the patients without diabetes, 5.4%, and there was statistically significant difference（P〈0.05）; in the pulpitis group, there was no statistically significant difference between the total effective rate of the patients with and without diabetes（P〉0.05）; in the periapical periodontitis group, the total effective rate of the patients with diabetes, 20.0%, was obviously lower than that of the patients without diabetes, 67.6%, and there was statistically significant difference（P〈0.05）. Conclusion For patients with pulpitis which shows lesser infection and limited lesion, there is no significant difference between the clinical manifestations of those with and without diabetes, but for patients with periapical periodontitis which shows severe infection and larger lesions, there is. Therefore in treatment of patients with periapical periodontitis combined with diabetes, blood glucose control and complication management should be conducted.