牙周膜龈手术患者术前焦虑及术后生活质量调查分析

Investigation of preoperative anxiety and postoperative quality of life in patients with periodontal mucogingival surgery

目的 :了解牙周膜龈手术患者术前焦虑程度及术后生活质量,为预防膜龈手术患者术前焦虑及提高术后生活质量提供依据。方法:根据纳入及排除标准,随机选取26例牙周膜龈手术患者,包括游离龈移植术(free gingival graft,FGG)13例,上皮下结缔组织移植术(subepithelial connective tissue graft,CGT)13例。对纳入患者进行焦虑评价,包括焦虑自评量表(self-rating anxiety scale,SAS)、改良成人牙科焦虑量表(modified dental anxiety scale,MDAS);术后生活质量相关参数评价,包括疼痛评价(VAS视觉疼痛量表)、临床表现评价(肿胀、出血、恶心、口腔异味)、口腔功能评价(咀嚼、说话、睡眠、工作)。采用SPSS 18.0软件包对数据进行统计学分析。结果:患者术前SAS分值为(44.33±11.99)分,其中焦虑患者4例,占15.38%;术前MDSA分值为(9.85±2.41)分,其中牙科焦虑患者4例,占15.38%。术后1、3、5、7、10 d VAS值分别为中度疼痛(4.54±1.32)、轻度疼痛(3.31±1.31)、轻度疼痛(2.00±1.14)、无痛(0.70±0.72)、无痛(0.08±0.27)。其中,FGG术术后1、3、5 d VAS值显著大于CTG术(P<0.05)。膜龈手术后不适最常见的为肿胀、出血、影响咀嚼和讲话,肿胀、影响咀嚼和讲话持续至术后7 d,出血现象持续至术后5 d。其中,FGG术术后不适显著高于CTG术。结论:膜龈手术术前焦虑患者约为15.38%。术后主要临床不适症状为术后1～7 d内中度至轻度疼痛、肿胀、出血、影响咀嚼和讲话。CTG术对患者生活质量的影响显著小于FGG术。

PURPOSE:To evaluate preoperative anxiety and postoperative quality of life in patients with periodontal mucogingival surgery,and provide a theoretical basis for preventing preoperative anxiety and improving postoperative quality of life in mucogingival surgery.METHODS:According to the inclusion and exclusion criteria,26 patients with mucogingival surgery were randomly selected,including 13 cases undergoing free gingival graft and 13 cases undergoing subepithelial connective tissue graft.All patients were asked to answer the following questionnaires which included selfrating anxiety scale(SAS),modified dental anxiety scale(MDAS),pain evaluation using visual pain scale(VAS),clinical performance evaluation(swelling,bleeding,nausea,oral odor),and oral function evaluation(chewing,speaking,sleeping,working).Data analysis was performed using SPSS 18.0 software package.RESULTS:The preoperative SAS score was44.33±11.99,4 patients had anxiety,accounting for 15.38%.The preoperative MDSA score was 9.85±2.41,4 patients had anxiety,accounting for 15.38%.The VAS values at 1 day,3 days,5 days,7 days,and 10 days after surgery were moderate pain(4.54±1.32),mild pain(3.31±1.31),mild pain(2.00±1.14),and painless(0.70±0.72),painless(0.08±0.27).The VAS values at 1 day,3 days,and 5 days after FGG were greater than those after CTG(P<0.05).The most common discomforts after mucogingival surgery were swelling,bleeding,disturbance in chewing and speech.Swelling,disturbance in chewing and speech persisted until 7 days after surgery,and bleeding continued until 5 days after surgery.The postoperative discomfort of FGG was significantly higher than that of CTG.CONCLUSIONS:Four had preoperative anxiety prior to mucogingival surgery.The main clinical symptoms after surgery were moderate to mild pain,swelling,bleeding,disturbance in chewing and speech within 1-7 days after surgery.The effect of CTG on the quality of life of patients was significantly less than that of FGG.