本文選題：齲風(fēng)險評估　切入點：齲病管理　出處：《遵義醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:為使有限的口腔衛(wèi)生資源得到優(yōu)化利用,本課題將探索齲病風(fēng)險評估與管理在小學(xué)口腔公共衛(wèi)生項目中的應(yīng)用,為今后口腔公共衛(wèi)生服務(wù)提供參考。方法:通過檢索文獻、咨詢專家和結(jié)合我市兒童齲病流行特點,確定小學(xué)口腔公共衛(wèi)生中應(yīng)用的齲病風(fēng)險評估與管理標(biāo)準(zhǔn)。在遵義市匯川區(qū)通過分層整群抽樣法抽取遵義市匯川區(qū)7所小學(xué)一至五年級學(xué)生,共3591人。按照本研究中的齲病風(fēng)險評估內(nèi)容,對兒童進行口腔檢查和齲危險因素調(diào)查,評估兒童齲病風(fēng)險性:低風(fēng)險、中風(fēng)險或高風(fēng)險。按風(fēng)險評估等級對兒童進行管理:高風(fēng)險兒童給予口腔健康教育、局部涂氟、窩溝封閉(pit and fissure sealant,PFS)和非創(chuàng)傷性修復(fù)治療(atraumatic restorative treatment,ART)干預(yù);中風(fēng)險兒童給予口腔健康教育、局部涂氟和ART干預(yù);低風(fēng)險兒童隨機分為A組和B組,A組給予口腔健康教育;B組給予口腔健康教育、局部涂氟和PFS。通過對所有研究兒童在口腔健康教育前后的口腔健康知識掌握情況、一年后齲病發(fā)病率情況和各項口腔預(yù)防干預(yù)措施所花費的成本進行分析,評價齲病風(fēng)險評估與管理在小學(xué)口腔公共衛(wèi)生項目中應(yīng)用的效果。結(jié)果:1、本次研究的遵義市匯川區(qū)7所小學(xué)一至五年級學(xué)生共3591名,男1886人,女1705人,患齲兒童有2343人,患齲率達(dá)65.25%,齲均為2.79,齲齒充填構(gòu)成比為4.07%。2、3591名研究對象低風(fēng)險人數(shù)為906人,中風(fēng)險人數(shù)為1281人,高風(fēng)險人數(shù)為1404人。在不同患齲風(fēng)險等級中,低、中、高風(fēng)險的齲失補牙數(shù)分別為0、1876和8150,齲均分別為0、1.46和5.80。經(jīng)統(tǒng)計分析,齲風(fēng)險分布不存在性別差異(P0.05);不同年級和是否為農(nóng)民工子女在各齲風(fēng)險分組中的分布均有差異(P0.05),一至三年級和農(nóng)民工子女兒童齲高風(fēng)險人數(shù)所占比例較高。3、一年后復(fù)查低風(fēng)險A組、低風(fēng)險B組、中風(fēng)險組和高風(fēng)險組兒童的齲病發(fā)病率分別為5.99%、5.57%、6.59%和8.03%,其差異無統(tǒng)計學(xué)意義(P0.05);新發(fā)齲均分別為0.08、0.08、0.09和0.12,無統(tǒng)計學(xué)意義(P0.05)。4、口腔健康教育前患齲低風(fēng)險A組、B組、中風(fēng)險組和高風(fēng)險組兒童的口腔健康知識掌握率分別為72.22%、72.08%、56.62%和47.44%,各組間存在差異(P0.05);正確刷牙率分別為75.35%、75.13%、47.96%和36.13%,各組間存在差異(P0.05)�？谇唤】到逃蟮惋L(fēng)險A組、低風(fēng)險B組、中風(fēng)險組和高風(fēng)險組兒童的口腔健康知識掌握率分別為88.40%、89.20%、87.66%和87.78%,差異無統(tǒng)計學(xué)意義(P0.05);正確刷牙率分別為81.67%、82.41%、81.74%和83.02%,差異無統(tǒng)計學(xué)意義(P0.05)。5、對本研究進行成本分析得出口腔檢查及風(fēng)險評估、口腔健康教育、局部涂氟、窩溝封閉和ART的平均每人成本分別為5.26元、1.44元、32.71元、35.63元和46.40元。低風(fēng)險A組、低風(fēng)險B組、中風(fēng)險組和高風(fēng)險組兒童平均成本分別為6.70元/人、76.18元/人、57.30元/人、115.40元/人。結(jié)論:1、齲病風(fēng)險評估中,齲高風(fēng)險主要集中在一至三年級和農(nóng)民工子女兒童,提示對這部分兒童應(yīng)進行重點防治。2、齲病風(fēng)險評估與管理在小學(xué)口腔公共衛(wèi)生項目中的應(yīng)用,對口腔醫(yī)療資源有一個合理的分配作用,使齲高風(fēng)險兒童得到重點防治,從而控制兒童齲病的發(fā)生與發(fā)展,值得在口腔公共衛(wèi)生項目中推廣。
[Abstract]:Objective: to make the oral hygiene of limited resources to optimize use, this paper will explore the application of caries risk assessment and management in primary school dental public health project, for the future of dental public health service to provide the reference. Methods: through literature retrieval, expert consultation and combined with the epidemic characteristics of dental caries of children in our city, to determine the application of primary school dental public health the caries risk assessment and management standard. In Zunyi City, Huichuan District 7 primary school by stratified cluster sampling method in Zunyi city of Huichuan District to the fifth grade students, a total of 3591 people. According to the study of caries risk assessment, oral examination and caries risk factors of children were investigated: low risk assessment of dental caries in children risk, risk or high risk. According to the level of risk assessment for the management of children: children at high risk for oral health education, topical fluoride, sealant (pit and fissure s Ealant, PFS) and atraumatic restorative treatment (atraumatic restorative treatment, ART) intervention; risk in children given oral health education, topical fluoride and ART intervention; low risk children were randomly divided into A group and B group, A group received oral health education; B group received oral health education, and topical fluoride PFS. of all study children to grasp the situation in oral health knowledge and oral health education, analysis of the cost for a year after the incidence of dental caries and the oral preventive interventions cost, application evaluation and management of caries risk assessment in primary school oral in public health project. Results: 1, one to the fifth grade students the study of the 7 primary school in Zunyi city of Huichuan District a total of 3591 patients, male 1886, female 1705, Cary children have 2343 people, the caries rate was 65.25%, DMFT was 2.79, the filling ratio of 4.07 subjects with low%.23591 The risk for the number 906, the risk for the number 1281, the high risk population of 1404 people. The risk level of different caries, low risk, high DMFT score were 01876 and 8150, DMFT were 0,1.46 and 5.80. by statistical analysis, the distribution of caries risk there is no gender difference (P0.05) in different grades; and whether the children of migrant workers are the distribution of differences in the caries risk in a group (P0.05), one to the third grade and the children of migrant workers children caries in high risk population accounted for a higher proportion of.3, a year after the review of low risk and low risk group A, B group, middle risk group and high risk children the incidence of caries was 5.99%, 5.57%, 6.59% and 8.03%, the difference was not statistically significant (P0.05); new caries were 0.08,0.08,0.09 and 0.12 respectively, without statistical significance (P0.05).4, oral health education before the low caries risk in A group, B group, middle risk group and high risk group of children oral health Health knowledge rate were 72.22%, 72.08%, 56.62% and 47.44%, there are differences between the groups (P0.05); the correct brushing rate were 75.35%, 75.13%, 47.96% and 36.13%, there are differences between the groups (P0.05). The low risk group A oral health education, low risk group B, oral health knowledge in risk groups of children and the high risk group mastery rates were 88.40%, 89.20%, 87.66% and 87.78%, the difference was not statistically significant (P0.05); the correct brushing rate were 81.67%, 82.41%, 81.74% and 83.02%, the difference was not statistically significant (P0.05.5), this paper analyzed the cost and risk assessment of oral examination, oral health education. Topical fluoride, the average cost of the fissure and ART were 5.26 yuan, 1.44 yuan, 32.71 yuan, 35.63 yuan and 46.40 yuan. Low risk and low risk group A, B group, middle risk group and high risk group of children the average cost was 6.70 yuan / person, 76.18 yuan / person, 57.30 yuan / person, 115.40 yuan / person. Conclusion: 1. The caries risk assessment in high caries risk is mainly concentrated on the children to the third grade and that of children of migrant workers, these children should be the focus of prevention and treatment of.2, the application of dental caries risk assessment and management in primary school dental public health project, a reasonable allocation of oral cavity medical resources, the high risk of caries children focus on prevention, so as to control the occurrence and development of dental caries in children, worthy of promotion in dental public health projects.

【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R788.1

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