陈旧性心肌梗死患者开髓治疗安全性的探讨

A study on safety of opening pulp chamber therapy for patients with a history of remote myocardial infarction

目的 探讨陈旧性心肌梗死患者开髓治疗的安全性及适应证和禁忌证。方法 对 1组患急、慢性牙髓炎 ,合并有陈旧性心肌梗死的患者 ,在开髓治疗过程中 ,进行血压、心率、心电图变化的监护观察。结果 在开髓治疗过程中 ,患者在局部注射麻醉剂及开髓过程中引起血压升高 ,麻醉中平均升高 1 2 52 /8 0 4mmHg(1mmHg=0 1 33kPa) ,开髓时平均升高 1 5 43/8 0 0mmHg ;心率加快 ,麻醉中平均加快 4 0 2次 /分 ,开髓时平均加快 6 37次 /分 ;8例患者因原有冠状动脉供血不足导致心电图变化。结论 本组大部分陈旧性心肌梗死患者可耐受开髓治疗 ,但术前应详细全面检查 ,对患者的心脏情况、精神状态及诊室的设备条件等做出估计 ,并应在心电监护下进行操作。本组例数尚少 ,最后结论有待进一步研究。

Objective To study the indication and contraindication of opening pulp chamber therapy for patients with a history of remote myocardial infarction Methods Blood pressure(BP), heart beat rate and electrocardiographic examination were determined during opening pulp chamber therapy in patients with acute and chronic pulpititis and a history of remote myocardial infarction Results High blood pressure and quick heart beat were found during local anaesthetic in jection and opening of pulp chamber(during local anaesthetic injection BP increased by 12 52/8 04 mmHg,heart rate by 4 02 times/min;during opening of pulp chamber BP and heart rate increased by 15 43/8 0 mmHg,6 37 times/min respectively) Electrocardiogram showed myocardial ischemic pattern deteriorated in some patients with the history of coronary insufficiency Conclusions Most patients can bear it Comprehensive physical examinations, evaluations of the patients′ cardial status, mental state and indispensible equipment are necessary The therapy is recommended to be operated under the monitor electrocardiographiy for the safety of the patients