50%笑气/氧气混合吸入镇静在成人牙科焦虑症患者阻生齿拔除术中的应用

Application of 50% Nitrous Oxide/Oxygen Mixed Inhalation Sedation in Impacted Teeth Extraction with Dental Anxiety Adult

目的研究50%笑气/氧气混合吸入镇静应用于成人牙科焦虑症患者高、中位阻生齿拔除术的临床效果。方法选择2018年5月—8月在广州医科大学附属口腔医院颌面外科门诊拔除下颌高、中位近中阻生齿并伴有牙科焦虑症的成人患者100例,按随机数表法分为观察组(n=50)和对照组(n=50),观察组采用50%笑气镇静辅以局麻下拔牙,对照组按照常规局麻下拔牙。比较2组术前、术中、术后的血压(BP)、心率(HR)、血氧饱和度(SpO2)、拔牙操作时间,记录并比较2组患者术前和术后的牙科焦虑评分。结果观察组在整个手术过程中BP、HR、SpO2变化无统计学意义(P>0.05),术后焦虑评分明显下降,与本组术前比较差异有统计学意义(P<0.05);对照组术中和术后的BP、HR与本组术前比较有统计学意义(P<0.05),SpO2无明显变化,术前和术后焦虑评分对比无统计学意义(P>0.05);观察组的拔牙操作时间明显短于对照组,差异有统计学意义(P<0.05)。结论使用50%笑气/氧气混合吸入镇静可以降低牙科焦虑症患者的焦虑程度,稳定患者的生命体征,缩短拔牙操作时间,值得推广应用。

Objective To study the clinical effect of 50%nitrous oxide/oxygen mixed gas inhalation sedation in extraction of impacted teeth in adult dental anxiety patients.Methods From May 2018 to August 2018,100 adult patients with mandibular impacted teeth and dental anxiety were selected.They were randomly divided into observation group(50 cases)and control group(50 cases).The observation group was treated with 50%nitrous oxide sedation combined with toponarcosis,while the control group was treated with conventional toponarcosis to extract teeth.Blood pressure(BP),heart rate(HR),oxygen saturation(SpO2)and extraction time were recorded before,during and after operation in two groups.Dental anxiety scores before and after operation.Data were analyzed statistically.Results The changes of BP,HR and SpO2 in the observation group were stable during the whole operation(P>0.05)and the scores of anxiety after operation decreased significantly(P<0.05);the BP and HR in the control group were significantly different from those before operation(P<0.05),but there was no significant change in SpO2,and there was no significant difference in the time of extraction and the scores of anxiety after operation(P>0.05).The extraction time of the observation group was significantly lower than that of the control group(P<0.05).Conclusion The use of 50%nitrous oxide/oxygen inhalation sedation can reduce the anxiety level of dental anxiety patients,stabilize the vital signs of patients,and shorten the extraction operation time.It is worth popularizing and applying.