120例全麻下儿童牙科治疗回顾分析

Dental treatment under general anesthesia among pediatric patients in 120 consecutive cases:a retrospective study

目的:调查接受牙科全麻(dental general anesthesia,DGA)治疗患儿的牙科治疗状况。方法:选择2017年6月—2019年11月于昆明医科大学附属口腔医院儿童口腔科接受DGA治疗的18岁以下患者,收集患儿基本信息、DGA治疗原因、麻醉及插管方式、诊疗内容、治疗时间及复诊情况。采用SPSS 26.0软件包对数据进行统计学分析。结果:共纳入120例患儿,男性占58.3%,以3~6岁患儿全麻治疗需求最高(85.0%)。恐惧牙科治疗,非药物行为管理无效是低龄儿童选择DGA治疗的首要因素;6岁以上儿童选择DGA最常见的原因为精神智力障碍(38.9%)及患方要求(38.9%)。人均治疗(15.16±3.42)颗牙,每颗牙平均耗时约12.26 min。龋齿充填术、根管治疗术以及乳牙预成冠(包括前牙树脂透明成形冠套和后牙金属预成冠)修复是主要治疗项目。DGA术后1周,98.3%的患儿无不适感。2017—2019年间选择DGA治疗的患者人数呈上升趋势。结论:DGA可快捷、安全、有效解决恐惧牙科治疗、非药物行为管理无效及精神智力障碍儿童的口腔问题,DGA在患者中的接受度呈上升趋势。在经济欠发达地区,需大力推广DGA培训及相关扶持项目,以满足治疗需求。

PURPOSE:To investigate the clinical features of children who received treatment under dental general anesthesia(DGA).METHODS:The clinical records of dental patients below 18 years old who were treated under DGA at the Department of Pediatric Dentistry,Affiliated Dental Hospital of Kunming Medical University during June 2017 to November 2019 were obtained,including the baseline information,causes for DGA,anesthesia methods,intubation methods,treatment items,treatment time and follow-up visits.SPSS 26.0 software package was used to analyze the data.RESULTS:A total of 120 patients were included,58.3%were males,and children aged 3 to 6 years showed the highest demand for DGA(85.0%).Fear of dental treatment,ineffective non-drug behavior management was the main causes for DGA in young children,while the most common causes for children over 6 years old to choose DGA were mental retardation(38.9%)and patients'needs(38.9%).The average number of teeth treated was(15.16±3.42)for each child,and the average time for treating one tooth was 12.26 min.Restoration,root canal treatment and primary teeth pre-forming crown(including anterior preformed resin transparent crown and posterior preformed metal crown)were the main treatment items.At 1-week follow-up visits,98.3%of children had no discomfort.During 2017 to 2019,there was an increasing tendency in the number of patients who chose DGA in the authors' institute. CONCLUSIONS: The dental issues of children with fear of dental treatment, ineffectiveor non-drug behavior management or mental retardation can be treated under DGA conveniently, safely and efficiently. The acceptance rate of DGA among pediatric patients is on the rise. DGA training programs and related support projects are needed to meet the treatment demands among patients in less developed areas.