口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (2): 144-147.DOI: 10.13701/j.cnki.kqyxyj.2021.02.012

• 口腔麻醉学研究 • 上一篇    下一篇

日间全麻下儿童口腔治疗后恢复及影响因素研究

刘冰, 冯彩华, 张国良, 张亚秋, 梁丽荣, 王沛娟, 闫维, 张惠*   

  1. 军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔生物工程技术研究中心,第四军医大学口腔医院麻醉科 陕西 西安 710032
  • 发布日期:2021-02-11
  • 通讯作者: 张惠,E-mail:zhanghuifmmua@163.com
  • 作者简介:刘冰(1986~ ),女,辽宁丹东人,主治医师,硕士,主要从事日间全麻、口腔镇静镇痛相关研究。

Study on Recovery Quality and Related Influencing Factors after Pediatric Dental Therapy under Ambulatory General Anesthesia

LIU Bing, FENG Caihua, ZHANG Guoliang, ZHANG Yaqiu, LIANG Lirong, WANG Peijuan, YAN Wei, ZHANG Hui*   

  1. State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Disease & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Anesthesiology, School of Stomatology, the Fourth Military Medical University, Xi’an 710032, China
  • Published:2021-02-11

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摘要： 目的:探讨日间全麻下儿童口腔治疗后恢复情况及相关影响因素。方法:日间全麻下口腔治疗患儿418例,年龄2~6岁,ASA分级Ⅰ或Ⅱ级。采用咽喉疼痛、咳嗽、声音嘶哑评分系统及术后恢复质量量表评价麻醉后24 h恢复情况。选择性别、年龄、麻醉时长、治疗牙齿数、七氟醚用量作为麻醉后24 h可能影响恢复因素进行分析。性别分为男、女两组;年龄分为0~36个月、36~48个月、>48个月3组;麻醉时长分为0~120 min、120~180 min、>180 min 3组;治疗牙齿数分为0~12颗、12~15颗、>15颗3组;七氟醚用量分为0~15 mL、15~20 mL、＞20 mL 3组。结果:麻醉后24 h咽喉疼痛、咳嗽、声嘶以轻度为主,发生率分别为18.4%、22.3%、23%。轻度、中度术后恶心呕吐(PONV)发生率分别为8.4%、0.2%。轻度、中度、重度牙齿疼痛的发生率分别为44.0%、13.2%、0.9%。轻度情绪低落及焦虑紧张发生率30.4%、19.9%。不同性别分组中,咳嗽和PONV发生差异有统计学意义(P<0.05)。不同麻醉时长分组中,PONV和情绪低落差异有统计学意义(P<0.05)。治疗牙齿数分组中,咽喉疼痛和声音嘶哑差异有统计学意义(P<0.05)。不同年龄与七氟醚用量分组中,各项观察指标差异均无统计学意义。结论:性别、麻醉时长、治疗牙齿数量是日间全麻下儿童口腔治疗后恢复的影响因素。日间全麻下儿童口腔治疗后恢复质量仍有提升空间。

关键词: 全身麻醉, 儿童口腔治疗, 恢复, 术后

Abstract: Objective: To explore the recovery quality and related influencing factors of pediatric dental therapy under ambulatory general anesthesia. Methods: A total of 418 children, aged 2-6 years old, American Society of Anesthesiologists physical status being Ⅰ or Ⅱ, with dental caries receiving dental therapies under ambulatory general anesthesia were included. Scoring system for sore throat, cough, hoarseness, and post-operative quality recovery scale were used to evaluate the recovery quality 24 h after general anesthesia. The recovery of each item after anesthesia was analyzed. Meanwhile five possible related influencing factors were analyzed, including gender, age, duration of anesthesia, number of teeth treated, and dosage of sevoflurane. Results: The sore throat, cough, and hoarseness were mainly mild at 24 h after general anesthesia, the incidences were 18.4%, 22.3%, and 23% respectively. The incidence of mild and moderate postoperative nausea and vomiting (PONV) were 8.4% and 0.2%, respectively. The incidences of mild, moderate, and severe toothache were 44.0%, 13.2%, and 0.9%, respectively. The incidence of mild depression and anxiety were 30.4% and 19.9%. There were significant differences in cough and PONV between different genders (P<0.05). There were significant differences in PONV and depression among different anesthesia duration groups (P<0.05). There were significant differences in sore throat and hoarseness among different number of teeth treated groups (P<0.05). There was no statistical significance in the different age groups and sevoflurane dosage groups. Conclusion: Gender, anesthesia duration, and number of teeth treated have some influence on the recovery of children receiving pediatric dental therapy under ambulatory general anesthesia. There is still some room for the improvement of the recovery quality after pediatric dental therapy under ambulatory general anesthesia.

Key words: general anesthesia, pediatric dental therapy, recovery, postoperative