牙齿开髓治疗对老年心血管病患者心率、血压、心电图的影响

Effects of endodontic treatment on heart rate, blood pressure and electrocardiogram of elderly patients with cardiovascular diseases

目的 探讨老年心血管病患者在心电监护下进行牙齿开髓治疗的安全性。 方法 对2 33例患急、慢性牙髓炎同时伴心血管疾病的老年患者 (患病组 )及 32例无心血管病史的老年患者(对照组 )牙齿开髓治疗全过程进行血压、心率、心电图的监测观察。 结果 患病组和对照组局麻时 ,血压分别平均升高 14 / 6、14 / 6mmHg(1mmHg =0 133kPa) ;心率平均加快 4 8、4 1次 /min。术中患病组及对照组血压分别平均升高 16 / 9、19/ 11mmHg ;心率加快 6 4、5 9次 /min。与术前相比 ,差异有显著性 (P <0 0 5 ) ;各组之间在术前、麻醉中、麻醉后 5min、术中、术后心率、血压的变化相比 ,差异无显著性 (P >0 0 5 )。部分老年心血管病患者术中出现心电图改变。 结论 老年心血管疾病患者在心电监护下进行开髓治疗是可行的。

Objective To study the safety of opening pulp chamber therapy for elderly patients with cardiovascular diseases. Methods Blood pressure, heart rate and electrocardiography were examined during the treatment by opening of pulp chamber for patients with acute and chronic pulpititis and cardiovascular diseases. Patients without cardiovascular disease were used as controls. Results Both blood pressure and heart rates were increased during local anesthetic injection(14/6 mm Hg, 14 4/6 6 mmHg; 4 8, 4 1 times/min) and during the opening of pulp chamber(16/9 mm Hg, 19/12 mm Hg; 6 4, 5 9 times/min) for both patients and control groups with statistically significant differences compared with that before operation. But there was no statistically significant differences between the patients with cardiovascular diseases and the controls during the local anesthetic injection and the opening of pulp chamber. Electrocardiogram showed myocardial ischemia deteriorated in some patients with cardiovascular diseases. Conclusions Endodontic treatment under monitoring by electrocardiography is safe and can be recommended to the elderly patients with cardiovascular diseases