微创拔牙术拔除阻生智牙的疼痛、应激反应及安全性研究

Perioperative Pain,Stress Response and Safety of Extraction of Impacted Wisdom Teeth by Minimally Invasive Tooth Extraction

目的探讨微创拔牙术拔除阻生智牙围术期疼痛、应激反应及安全性。方法选取本院2019年1月—2020年10月收治的阻生智牙实施拔除术患者80例。按照随机数字表法分为两组,各40例。观察组实施微创拔牙术,对照组行传统拔牙法,比较两组术前准备时间及手术时间,不同观察时间点两组疼痛NRS评分,两组术后3 d两组炎症及氧化应激因子水平,统计两组并发症发生情况。结果观察组术前准备时间及手术时间均显著短于对照组(P<0.05),术后1 d、术后3 d及术后7 d,观察组疼痛NRS评分均显著低于对照组(P<0.05),术后3 d,观察组炎症因子hs-CRP及TNF-α水平低于术后3 d随访时的对照组(P<0.05),氧化应激因子中MDA水平低于术后3 d随访时的对照组(P<0.05),SOD水平高于术后3 d随访时的对照组(P<0.05),观察组出现牙神经损伤、邻牙损伤及断根的比例显著低于对照组(P<0.05)。结论针对阻生智牙实施微创拔牙术,能有效的缩短手术时间,缓解患者疼痛,降低炎症反应,提高机体抗氧化能力,且并发症少,安全性高。

Objective To explore the perioperative pain,stress response and safety of extraction of impacted wisdom teeth by minimally invasive tooth extraction.Methods 80 cases with impacted wisdom teeth from January 2019 to October 2020 were selected for extraction were randomly divided into two group according to random number method,each 40 cases.The observation group was treated with minimally invasive tooth extraction,the control group was treated with traditional tooth extraction.Then the preoperative preparation time and operation time of the two groups were compared.The pain NRS scores of the two groups at different observation time points,the levels of inflammation and oxidative stress factors of the two groups 3 days after operation were compared,and the complications of the two groups were counted.Results The preoperative preparation time and operation time of the observation group were significantly shorter than those of the control group(P<0.05).The pain NRS scores of the observation group were significantly lower than those of the control group on the 1^(st),3^(rd) and 7^(th) day after operation.On the 3^(rd) day after operation,the levels of inflammatory factors hs-CRP and TNF-α in the observation group were lower than those in the control group at the 3^(rd) day after operation(P<0.05).The level of MDA in oxidative stress factors was lower than that in the control group(P<0.05),and the level of SOD on the 3^(rd) day after operation was higher than that in the control group(P<0.05).The incidence of tooth nerve injury,adjacent tooth injury and root breakage in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Minimally invasive tooth extraction for impacted wisdom teeth can effectively shorten the operation time,relieve the pain of patients,reduce the inflammatory reaction and improve the antioxidant capacity of the body,with few complications and high safety.