本文選題：老年人 + 心血管疾病��； 參考：《上海交通大學(xué)》2014年碩士論文

【摘要】：目的：分析老年心血管疾病患者監(jiān)護(hù)拔牙的安全性。 方法：選取2008-2012年上海交通大學(xué)醫(yī)學(xué)院附屬第九人民醫(yī)院心血拔牙門診就診的13527例患者的調(diào)查資料，對其年齡、性別構(gòu)成比和所患疾病的種類等進(jìn)行比較研究；通過對7077例老年高血壓或合并其他慢性疾病的患者進(jìn)行全程心電監(jiān)護(hù)下拔牙，分析各因素對拔牙風(fēng)險性的影響；隨機(jī)選取有原發(fā)性高血壓的C組患者，對其拔牙過程進(jìn)行心電圖或Holter記錄，比較兩種檢測方法對心血管事件的檢出率。 結(jié)果：（1）該門診就診人群以老年人為主（75.3%），70-79歲為就診高峰年齡段；所患疾病以高血壓、冠心病、心律失常、腦血管意外、糖尿病等為主。 （2）老年高血壓患者拔牙安全性分析中，對各個年齡層、性別、以及不同合并疾病進(jìn)行分組比較，，各組間不同時間點的收縮壓存在顯著性。性別不同在心率變化上有顯著差別。 （3） Holter對拔牙過程中心血管事件的檢出率明顯高于普通心電圖，兩者間有統(tǒng)計學(xué)差異。 結(jié)論：（1）該門診以老年高血壓患者為主，其次冠心病、心律失常等。 （2）年齡的增加、多種疾病的并存加大了拔牙風(fēng)險；運用危險性評分能快速判斷拔牙風(fēng)險性。 （3） Holter在檢出率方面比普通心電圖更優(yōu)秀，可在高危拔牙人群中推廣。
[Abstract]:Objective: to analyze the safety of dental extraction in elderly patients with cardiovascular disease. Methods: from 2008 to 2012, the data of 13527 patients who were treated in the outpatient department of heart blood extraction in the Ninth people's Hospital affiliated to Shanghai Jiaotong University Medical College were investigated, and their age, sex composition ratio and kinds of diseases were compared and studied. The effects of various factors on the risk of tooth extraction were analyzed in 7077 elderly patients with hypertension or other chronic diseases by electrocardiographic monitoring, and the patients in group C with essential hypertension were randomly selected. Electrocardiogram (ECG) or Holter were recorded during tooth extraction, and the detection rate of cardiovascular events was compared between the two methods. Results (1) the peak age of the outpatient was 75.3% and 70-79 years old, and the main diseases were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, diabetes mellitus and so on, and the main diseases were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, diabetes mellitus and so on. 2) in the analysis of the safety of tooth extraction in elderly patients with hypertension, the systolic blood pressure at different time points was significant in different age groups, sex and complicated diseases. Gender differences have significant differences in heart rate changes. 3) the detection rate of cardiovascular events in tooth extraction by Holter was significantly higher than that in normal electrocardiogram (ECG), and there was statistical difference between them. Conclusion (1) the outpatient was mainly elderly patients with hypertension, followed by coronary heart disease, arrhythmia and so on. 2) with the increase of age and the coexistence of many diseases, the risk of extraction is increased, and the risk of extraction can be judged quickly by using the risk score. (3) Holter is better in detecting rate than general ECG, and can be popularized in high risk population of tooth extraction.
【學(xué)位授予單位】：上海交通大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R54;R782.11

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