改良六手操作预防儿童牙科畏惧症的效果评价

Effects of improved six-hand operation technique on the prevention of dental anxiety in children

目的：观察并评价医护六手操作结合心理干预用于预防儿童牙科畏惧症（ CDF）的效果。方法将确诊为中龋或深龋的120例患儿随机分为六手组、四手组及常规组,每组各40例。六手组：1名护士配合1名医生工作的同时,巡回护士将健康教育和心理干预措施应用于患儿治疗前、中、后的全过程；四手组：1名护士配合1名医生工作,只进行简单的沟通,不做心理干预；常规组：1名护士配合2名医生工作,以医生独立操作为主,不做心理干预。3组患儿均接受常规的充填治疗。测量T1（患儿坐上牙椅治疗开始时）、T2（治疗开始后5 min）、T3（治疗结束后5 min）3个时间点患儿的脉搏和Corah′s牙科畏惧症评分,观察3组患儿的情绪变化情况。结果在T1、T2时间点比较,3组患儿脉搏的差异均有统计学意义（P〈0.01）。3组患儿牙科畏惧症评分经两两比较,六手组患儿焦虑程度最低,差异均有统计学意义（H=82.57,P〈0.05）。结论六手操作结合心理干预预防CDF优于四手操作和常规操作。

Objective To observe and assess the advantages of the six-hand operation combined with psychological intervention in preventing dental anxiety in children. Methods A total of 120 children who had been diagnosed with superficial or deep caries of dentin were randomly divided into three groups （ six-hand group, four-hand group and control group） with 40 cases in each group. The six-hand operation group： while one nurse cooperated with one doctor, the circuit nurse applied mental nursing and health education to the whole process （ the early, middle and late terms） of the treatment for the diseased children. The four-hand operation group： one nurse worked with one doctor and no psychological intervention except simple communication. The control group： one nurse worked with two doctors and the doctors′ did independent operation as the predominant treatment and no psychological intervention. The children in all the three groups received the routine filling treatment. We measured children′s pulse and Corah′s dental anxiety scale at T1 （ the children beginning of treatment at dental chair）, T2（5 min after treatment beginning）, and T3（5 min after treatment）. Results There was statistical significance in the differences of pulse between the groups at T1 and T2 （ P 〈0. 01）. The children acquire low anxiety scores when any two groups of three groups compared the scores of Corah′s dental anxiety scale （H=82. 57,P〈0. 05）. Conclusions The six-hand operation in combination with psychological intervention is superior to the four-hand operation and the routine operation in preventing dental anxiety in children.