计算机辅助口腔局部麻醉仪在高血压病拔牙患者中的应用效果

Application effectiveness of computer-aided oral local anesthesia apparatus on hypertension patients with tooth extraction

目的探讨高血压病拔牙患者应用计算机辅助口腔局部麻醉技术的临床护理效果。方法选取2014年1～12月在北京同仁医院口腔科预约拔牙的高血压病患者72例，将患者随机分为观察组和对照组，各36例。观察组采用无痛口腔局麻注射仪进行局部麻醉注射，对照组采用传统手动注射方式进行局部麻醉注射。麻醉前、中、后分别对患者进行改良牙科焦虑量表评分（MADS）、视觉模拟（VAS）标尺表评分，并测定血压和心率。结果观察组患者局麻注射时的VAS评分低于对照组，差异有统计学意义（t=3．321，P〈0．05）；观察组麻醉术后有86．11％（31／36）的患者焦虑评分下降，对照组中仅有38．89％（14／36），差异有统计学意义（X2=6．72，P〈0．05）。观察组有80．65％（25／31）的患者焦虑评分下降变为非牙科焦虑状态（MADS〈11分），对照组中有28．57％（4／14），差异有统计学意义（X2=6．93，P〈0．05）。对照组患者的血压在局麻注射中与注射前、注射后相比有明显上升（P〈0．05），观察组麻醉注射中血压、心率较麻醉前、麻醉后变化差异均无统计学意义（P〉0．05）。结论计算机辅助口腔局部麻醉技术可以有效控制患者牙科焦虑，减轻局麻注射的疼痛不适，有效稳定患者血压及心率，利于护理工作的顺利进行。

Objective To evaluate the effectiveness of clinical nursing on hypertension patients with tooth extraction by using computer-aided oral local anesthesia technology. Methods A total of 72 hypertension patients, who had tooth extraction and were selected from January 2014 to December 2014 in Beijing Tongren Hospital, were randomly divided into the observation group （36 cases） and the control group （36 cases）. The painless oral local anesthesia apparatus were used for patients in the observation group and the traditional manual injection of local anesthetic injection was used for these in the control group. The scores of modified dental anxiety scale （MDAS） and the visual analogue scale （ VAS ） was recorded, the blood pressure and the heart rate were measured in all cases before, during and after local anesthesia. Results The score of VAS in the observation during local anesthesia was significantly lower than that in the control group that VAS score decreased in 86. 11% patients （31/36） in the observation group comparing with 38.89% （14/36） in the control group （P 〈 0. 05 ）. The patients with anxiety was 80.65% （25/31 ） having decreasing and became to non,dental anxiety state （ MADS 〈 11 score） in the observation group and 28.57% （4/14） in the control group （ P 〈 0.05 ）. Blood pressure of patients in the control group significantly increased before, during and after anesthesia injection （P 〈 0.05 ）. There was no statistical difference comparing blood pressure and heart rate during anesthesia injection with these before and after anesthesia injection in the observation group （ P 〉 0. 05 ）. Conclusions The computer- aided oral local anesthesia technique can effectively control the dental anxiety, relieve pain in anesthesia injection and discomfort, effectively control blood pressure and heart rate, and is conducive to the smooth process of nursing work.