舒适化医疗技术在牙科恐惧症儿童口腔治疗中的临床对照研究

Clinical Comparative Study on Comfort Medical Technology in Oral Treatment of Children with Dental Phobia

目的:探讨舒适化医疗技术在牙科恐惧症(child dental fear,DF)儿童口腔治疗中的临床应用。方法:将纳入的94例CDF患儿根据治疗方法分为47例对照组(Ctrl)和47例实验组(Exp),Ctrl组采用传统束缚治疗,Exp组采用口腔舒适化治疗。比较两组治疗前后的恐惧程度[采用儿童畏惧调查表-牙科分量表(children's fear survey schedule-dental subscale,CFSS-DS)评估]、口腔相关生活质量[采用口腔健康相关生活质量量表(the early childhood oral health impact scale,ECOHIS)评估]和疼痛程度(采用Wong-Baker面部表情量表评估)及接诊时、治疗前、治疗后的心率变异性[相关指标心率(heart rate,HR)、低频功率(low frequency power,LF)、高频功率(high frequency power,HF)、LF/HF]。结果:Ctrl组患儿治疗后的CFSS-DS评分较治疗前明显升高,ECOHIS评分较治疗前明显降低(P<0.05);而Exp组治疗后的CFSS-DS评分和ECOHIS评分均明显低于治疗前和Ctrl组(P<0.05);与Ctrl组比较,Exp组患儿疼痛程度明显降低(P<0.05)。两组患儿治疗前的HR、LF和LF/HF水平均明显高于接诊时,而HF水平明显低于接诊时,且Exp组中上述指标变化幅度小于Ctrl组(P<0.05);同时,Exp组治疗后HR、LF和LF/HF水平较治疗前和Ctrl组降低;而HF水平较治疗前和Ctrl组明显升高(P<0.05)。结论:舒适化医疗技术不仅可降低CDF患儿恐惧与疼痛程度,提高口腔相关生活质量,还可减轻患儿心率变异性的改变,提升舒适度。

Objective:To explore the clinical application of comfort medical technology in the oral treatment of children with child dental phobia(CDF).Methods:Ninety-four children with CDF were divided into control(Ctrl)group and experimental(Exp)group,with 47 cases in each group.The Ctrl group received traditional restraint treatment,while the Exp group received oral comfort treatment.The levels of fear before and after treatment were compared between two groups,including the children's fear survey schedule-dental subscale(CFSS-DS),the early childhood oral health impact scale(ECOHIS),pain level(using the Wong Baker Facial Expression Scale),and Heart rate variability before and after treatment[using heart rate(HR),low frequency power(LF),high frequency power(HF),and LF/HF].Results:The CFSS-DS score of children in the Ctrl group significantly increased after treatment,while the ECOHIS score significantly decreased(P<0.05).However,the CFSS-DS score and ECOHIS score in the Exp group were significantly reduced than those before treatment and in the Ctrl group(P<0.05).Compared with the Ctrl group,the pain level of children in Exp group was significantly reduced(P<0.05).HR,LF,and LF/HF levels of the two groups of children before treatment were significantly higher than those at the time of diagnosis,while the HF levels were significantly lower than those at the time of diagnosis,and the changes in the above indicators in the Exp group were smaller than those in the Ctrl group(P<0.05).Meanwhile,the levels of HR,LF,and LF/HF in the Exp group decreased after treatment compared to those before treatment and the Ctrl group,the HF level was significantly higher than that before treatment and in the Ctrl group(P<0.05).Conclusion:Comfortable medical technology can not only reduce the fear and pain level of children with CDF,improve oral related quality of life,but also reduce changes in heart rate variability and improve comfort.