2型糖尿病患者拔牙创感染的危险因素分析及其护理对策

Analysis of Risk Factors for Post-Extractive Infection in Type 2 Diabetic Patients and Its Nursing Countermeasures

目的:分析2型糖尿病患者拔牙创感染的危险因素,并探究其预防护理对策。方法:采用巢式病例对照研究方法,选择2016年10月至2021年10月于北京医院口腔科接受拔牙手术后发生拔牙创感染的16例2型糖尿病患者为病例组,通过病例组的手术日期,检索同一术者在接近时间点进行的2型糖尿病患者拔牙手术,按照1:5频数匹配对照组90例。分析性别、年龄、吸烟、抗生素使用、拔牙数量、胰岛素依赖、愈合方式及慢性牙周炎等因素对拔牙创感染的影响。结果:单因素分析显示年龄 ≥ 65岁、吸烟、未服用抗生素及愈合方式为未缝合的2型糖尿病患者发生拔牙创感染率明显高于对照组(P < 0.05)。多因素Logistic回归分析显示吸烟和愈合方式为未缝合是影响拔牙创感染的独立危险因素(P < 0.05)。结论:吸烟和愈合方式是2型糖尿病患者拔牙创感染的影响因素,临床中应针对患者存在的高危因素进行针对性的护理,以降低拔牙创感染发生率。

Objective: To analyze the risk factors for post-extractive infection in type 2 diabetic patients and explore the preventive and nursing countermeasures. Methods: A nested case-control study was used to analyze 16 cases of post-extractive infection in the Department of Stomatology, Beijing Hospital from October 2016 to October 2021 (case group), in light of the operation date, all the exodontia at the closet time point by the same operator were retrieved, with 90 cases matched as control group according to 1:5. The influence of gender, age, smoking, antibiotics, tooth number, insulin resistance, healing pattern and chronic periodontitis on post-extractive infection was ana-lyzed. Results: Univariate analysis showed the post-extractive infection rates of type 2 diabetic pa-tients aged ≥ 65, smoking, non-taking antibiotics and without-suture were significantly higher than control group (P < 0.05). Multivariate analysis showed smoking and without-suture were in-dependent prognostic factors of post-extractive infection (P < 0.05). Conclusion: Smoking and healing pattern are prognostic factors of post-extractive infection in type 2 diabetic patients. To reduce the incidence rate of post-extractive infection in type 2 diabetic patients, targeted care should be carried out for patients with high risk factors in clinical practice.