表面麻醉联合STA在儿童多生牙拔除术的应用

Application of Topical Anesthesia Combined with STA in Extraction of Supernumerary Teeth in Children

目的:比较表面麻醉联合STA无痛麻醉与STA无痛麻醉、传统压力注射器局部麻醉在儿童多生牙拔除术中的应用效果。方法:选择5~14岁上颌前牙区多生牙患儿90例为研究对象,分为A、B、C三组,每组30例。A组为表面麻醉联合STA无痛麻醉;B组为STA无痛麻醉;C组为传统压力注射器局部麻醉,3组均采用唇腭侧局部浸润麻醉。记录3组患儿入室以及注射前中后的血压、心率、血氧饱和度数值。注射过程中,采用改良行为量表(MCHEOPS)对患儿行为进行评分;治疗结束时,患儿根据Wong-Baker面部表情量表评价麻醉时的疼痛程度。结果:在腭侧浸润麻醉时,A,B两组的疼痛程度小于C组(P<0.05),但A组和B组疼痛差异无统计学意义(P>0.05)。在颊侧浸润麻醉时,A组疼痛程度显著减轻(P<0.05)。患儿自身疼痛评价表明A组患儿疼痛值更低,差异有统计学意义(P<0.05)。A组注射前、中、后的血压、心率、血氧饱和度变化的差异无统计学意义,B组和C组注射后血压显著上升(P<0.05)。结论:在儿童多生牙拔除治疗中应用表面麻醉联合STA无痛麻醉的方法,能明显降低或消除患儿在注射过程中的疼痛。

Objective:To compare the effects of topical anesthesia combined with STA painless anesthesia,STA painless anesthesia,and traditional pressure syringe local anesthesia in the extraction of supernumerary teeth in children.Methods:Ninety children aged 5-14 years with supernumerary teeth in maxillary anterior teeth were randomly divided into three groups with 30 children in each group.Group A was topical anesthesia combined with STA painless anesthesia,group B was STA painless anesthesia,and group C was local anesthesia with traditional pressure syringe.All groups were treated with labial and palatal local infiltration anesthesia.The values of systolic blood pressure,diastolic blood pressure,heart rate,and blood oxygen saturation were recorded before and after injection.During the injection,the behavior of the children was scored by the modified behavior scale(MCHEOPS),and the degree of pain during anesthesia was evaluated according to the Wong-Baker facial expression scale at the end of treatment.Results:During palatal infiltration anesthesia,the degree of pain in group A and B was less than that in group C(P<0.05),but there was no significant difference between group A and group B(P>0.05).During buccal infiltration anesthesia,the degree of pain in group A was significantly alleviated(P<0.05).The self-pain evaluation of children showed that the pain value of children in group A was lower(P<0.05).There was no significant difference in blood pressure,heart rate,and blood oxygen saturation in group A before,during,and after injection,but the blood pressure in group B and group C increased significantly after injection(P<0.05).Conclusion:The application of topical anesthesia combined with STA painless anesthesia in the treatment of supernumerary tooth extraction in children can reduce the pain during injection.