牙周加速成骨正畸手术患者术前焦虑及术后生活质量的调查研究

Investigation of preoperative anxiety and postoperative quality of life in patients with periodontally accelerated osteogenic orthodontics surgery

目的了解牙周加速成骨正畸(periodontally accelerated osteogenic orthodontics,PAOO)手术患者术前焦虑程度及术后生活质量,为预防PAOO手术患者术前焦虑及提升术后生活质量提供理论依据。方法根据纳入及排除标准,选取45例PAOO手术患者。对纳入患者进行焦虑评价-焦虑自评量表(self-rating anxiety scale,SAS)、改良成人牙科焦虑量表(modified dental anxiety scale,MDAS)、术后生活质量相关参数评价-疼痛评价(VAS视觉疼痛量表)、临床表现评价(肿胀、出血、恶心、口腔异味)、口腔功能情况评价(咀嚼、说话、睡眠、工作)。采用SPSS 18.0软件包进行数据分析,采用定量、定性数据统计描述方法,评价PAOO手术围手术期患者术前焦虑及术后生活质量。结果45例患者术前SAS得分为(44.28±11.15)分,其中焦虑患者共10例占22.22%,术前MDAS得分为(9.29±2.78)分,其中牙科焦虑患者共8例占17.78%。术后1、3、5、7、10 d VAS值分别为中度疼痛(7.13±1.04)、轻度疼痛(3.98±1.05)、轻度疼痛(1.96±0.85)、无痛(0.31±0.51)、无痛(0.09±0.28)。PAOO手术术后常见临床表现为肿胀、出血,术后1、3、5、7、10 d不同程度肿胀情况为100.00%、100.00%、100.00%、95.66%、6.67%;术后1、3、5、7、10 d不同程度出血情况为97.78%、17.78%、8.89%、4.44%、0.00%。PAOO手术术后常见口腔功能情况为影响咀嚼和讲话,术后1、3、5、7、10 d不同程度影响咀嚼情况为100.00%、97.78%、73.33%、11.11%、4.44%;术后1、3、5、7、10 d不同程度影响讲话情况为100.00%、97.78%、77.78%、11.11%、4.44%。结论PAOO手术术前牙科焦虑患者约为17.78%。术后主要不适临床症状为术后1~7 d内中度至轻度疼痛,不同程度肿胀、出血,影响咀嚼和讲话。提示临床医生应尽量合理设计手术方式,优化护理流程,从而减轻患者紧张和焦虑心理及术后不适。

Objective To understand preoperative anxiety and postoperative quality of life in patients with periodontally accelerated osteogenic orthodontics(PAOO)surgery,and provide a theoretical basis for preventing preoperative anxiety and improving postoperative quality of life in PAOO surgery.Methods According to the inclusion and exclusion criteria,45 patients with PAOO surgery were randomly selected.All patients were asked to answer the following questionnaires which included self-rating anxiety scale(SAS),modified dental anxiety scale(MDAS),pain evaluation(VAS visual pain scale),clinical performance evaluation(swelling,bleeding,nausea,oral odor),and oral function evaluation(chewing,speaking,sleeping,working).Data analysis was performed using SPSS 18.0 software.The quantitative and qualitative statistical description methods were used to evaluate the preoperative anxiety and postoperative quality of life of patients with PAOO surgery.Results The preoperative SAS score of the 45 patients was 44.28±11.15,among whom 10 patients had anxiety accounting for 22.22%.The preoperative MDSA score was 9.29±2.78,among the 45 patients,8 patients had anxiety accounting for 17.78%.The VAS values 1,3,5,7,and 10 days after surgery were moderate pain(7.13±1.04),mild pain(3.98±1.05),mild pain(1.96±0.85),and painless(0.31±0.51),painless(0.09±0.28).The most common discomforts after PAOO surgery were swelling and bleeding.The degrees of swelling 1,3,5,7,and 10 days after surgery were 100.00%,100.00%,100.00%,95.66%,6.67%.The degrees of bleeding 1,3,5,7,and 10 days after surgery were 97.78%,17.78%,8.89%,4.44%,0.00%.The most common discomforts of oral function after PAOO surgery were the effects on chewing and speech.The degrees of the effects on chewing condition 1,3,5,7,and 10 days after surgery were 100.00%,97.78%,73.33%,11.11%,4.44%.The degrees of the effects on speech condition 1,3,5,7,and 10 days after surgery were 100.00%,97.78%,77.78%,11.11%,4.44%.Conclusion Approximately 17.78%of the patients have dental anxiety before PAOO surgery.The main clinical symptoms after surgery are moderate to mild pain,varying degrees of swelling,bleeding,disturbance in chewing and speech in 1-7 days after surgery.It is suggested that the clinicians should design the reasonable surgical method and optimize the nursing process to relieve the patients’anxiety and postoperative discomforts.