早期开髓缓解急性根尖脓肿伴颊间隙感染引起的疼痛

Early access opening of the dental pulp cavity helps relieving the pain caused by acute apical abscess with buccal space infection

目的评价对上颌磨牙急性根尖脓肿伴颊间隙感染患者进行早期患牙开髓的疼痛缓解效果,为临床提供参考。方法2015年7月至2019年3月由中山大学孙逸仙纪念医院口腔科收治的122例由上颌磨牙引起的急性根尖脓肿伴颊间隙感染患者(男71例、女51例),年龄16~63岁。采用随机数字表法分层分组、单盲、交叉、自身对照,按照切开排脓前是否接受开髓处理分为开髓组(男36例、女25例,共61例)和对照组(男35例、女26例,共61例),用视觉模拟评分法(VAS)评定患者切开排脓前、切开排脓后即刻、30min、1h、4h、12h、24h、2d、4d、7d的疼痛分值。采用SPSS25.0统计软件对VAS值进行分析。结果两组患者在切开排脓前VAS值差异无统计学意义(F=0,P=0.39)。切开排脓后即刻、30min、1h、4h、12h、24h开髓组的VAS值均显著低于相应对照组的VAS值,差异均有统计学意义(P<0.001),而切开排脓后2、4和7d开髓组的VAS值与相应对照组相比差异均无统计学意义(P>0.05)。所有患者均无并发症。结论上颌磨牙急性根尖脓肿伴颊间隙感染可在切开排脓前进行开髓引流从而缓解疼痛。

Objective To evaluate the pain relief effect of accessing opening of dental pulp in acute apical abscess with buccal space infection. Methods From July 2015 to March 2019 in Stomatology Department of Sun Yat.sen Memorial Hospital of Sun Yat-sen University,totally 122 patients suffering intense pain from acute apical abscess of maxillary molars with buccal space infection(71 males and 51 females)were stratified by genders and then randomly divided into two groups,namely the access group (36 males and 25 females)and the control group(35 males and 26 females). Patients of access group had their pathogenic teeth′s cavities open and drainage before the buccal space incision and drainage as the control group. And visual analogue scale(VAS)was used to record and analyze within 7 d. Results Before treatment,VAS scores of the access group and the control group are of no difference(F = 0,P = 0.39). After buccal space incision and drainage,the VAS score of both groups had decreased within 24 h, with the access group exhibiting a greater decrease immediately and at 30 min,1 h,4 h,12 h and 24 h than the control group did(P<0.001). Then at 2,4 and 7 d,VAS scores of the access group exhibited no difference with the control group (P>0.05),and patients of both groups had their pain relieved.Conclusion Accessing opening of the pathogenic teeth′s dental pulp before the buccal space incision and drainage helps effectively in relieving the pain caused by acute apical abscess accompanied with buccal space infections.