本文選題：口腔全麻技術(shù) + 兒童口腔　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的： 對不合作兒童進行全身麻醉下牙科治療的情況進行回顧性研究，并評價全麻下牙科治療的效果及相關(guān)影響因素。 方法： 1、本文對吉林大學(xué)口腔醫(yī)院兒童口腔科2011年12月至2013年7月進行全麻下牙科治療的60例不合作患兒的病歷資料進行回顧性研究。包括患兒的基本情況（年齡及性別）、選擇全麻的原因、全麻患兒的牙科治療內(nèi)容（術(shù)式及牙數(shù)）、治療時間及術(shù)中術(shù)后的不良反應(yīng)。 2、設(shè)置60例全麻下牙科治療患者為觀察組，選擇2013年1月至2013年7月的門診進行淺、中齲的齲齒充填術(shù)患兒60例作為對照組1，2013年1年至2013年7月的門診進行根管治療術(shù)患兒60例作為對照組2。觀察組及兩個對照組在性別和年齡方面的差異無統(tǒng)計學(xué)意義。復(fù)診檢查患者出現(xiàn)術(shù)后并發(fā)癥的情況，分析其成功率，并對常規(guī)齲齒充填、根管治療同全麻下進行相同術(shù)式的治療效果進行對比。 結(jié)果： 1、全麻下治療牙科疾病患兒男性38名、女性22名，年齡17～192個月，平均60.25個月。在3～4歲的兒童分布趨于集中傾向。家長選擇全麻下進行治療的最主要原因是患兒不配合，占總?cè)藬?shù)的90%（54/60）。人均治療牙齒11.42顆，每顆牙平均花費時間17.34min。根管治療術(shù)最多占43.50%，其次為間接蓋髓術(shù)25.70%、齲齒充填術(shù)16.20%、活髓切斷術(shù)7.59%、拔牙術(shù)3.50%、窩溝封閉術(shù)2.63%、纖維樁0.58%、成品冠0.29%。出現(xiàn)口腔全麻不良反應(yīng)發(fā)燒1例，黏膜壓迫性水腫1例，全身酸痛1例，創(chuàng)傷性口角炎2例，咬合不適3例。 2、齲齒充填術(shù)（淺、中齲）：三個月觀察組成功率為95.50%，對照組1為90.18%；六個月觀察組成功率為88.29%，對照組1為82.14%。根管治療術(shù)：三個月觀察組成功率為98.32%，對照組2為93.56%；六個月觀察組成功率為95.97%，對照組2為89.49%。三個月及六個月兩種術(shù)式的成功率，全麻治療顯著高于常規(guī)治療，，差異有統(tǒng)計學(xué)意義(P＜0.05)。 結(jié)論： 3-4歲兒童的牙科恐懼癥是選擇全麻下牙科治療主要因素。牙髓病、根尖周病的根管治療是全麻治療中最主要的治療方法。不合作兒童全麻下進行齲齒充填術(shù)和根管治療術(shù)可以獲得最佳治療效果，術(shù)后可能出現(xiàn)短暫的發(fā)熱、咬合不適等不良反應(yīng)。
[Abstract]:Objective: to evaluate the effect of dental treatment under general anesthesia and related factors in noncooperative children. Methods: 1. The medical records of 60 uncooperative children undergoing general anesthesia from December 2011 to July 2013 in the Department of Children's Stomatology, Jilin University Stomatology Hospital were retrospectively studied. Including the child's basic situation (age and sex), the reasons for choosing general anesthesia, The contents of dental treatment (method and number of teeth), treatment time and adverse reaction after operation and operation of children with general anesthesia. 2. 60 cases of dental treatment under general anesthesia were selected as the observation group, and the outpatients from January 2013 to July 2013 were selected as the observation group. 60 children with moderate caries were treated as control group and 60 children with root canal therapy were used as control group from 2013 to 2013. There was no significant difference in sex and age between the observation group and the two control groups. The postoperative complications were analyzed, and the results of routine dental caries filling, root canal therapy and general anesthesia were compared. Results: 1. 38 male and 22 female children with dental diseases were treated under general anesthesia. Their age ranged from 17 to 192 months (mean 60.25 months). Children aged 3 or 4 tend to be concentrated. The main reason for parents to choose general anesthesia is the lack of cooperation, accounting for 90% of the total number (54 / 60). 11.42 teeth were treated per capita, and the average time per tooth was 17.34 min. Root canal therapy accounted for 43.50%, followed by indirect pulp capping 25.70, caries filling 16.20, active pulp incision 7.59, extraction 3.50, fossa and sulcus closure 2.63, fiber post 0.58, and finished product crown 0.29. There were 1 case of fever, 1 case of mucosal compression edema, 1 case of systemic soreness, 2 cases of traumatic horn inflammation, 3 cases of malocclusion and 2 cases of dental caries filling. Middle caries): the observed composition power was 95.50 in three months, 90.18 in control group 1, 88.29 in six months, and 82.14 in control group 1. Root canal therapy: the observed composition power was 98.32 in three months, 93.56 in control group 2, 95.97 in six months and 89.49 in control group 2. The success rate of three and six months operation was significantly higher in general anesthesia than that in routine treatment (P < 0.05). Conclusion: dental phobia in children aged 3-4 years is the main factor of choosing dental treatment under general anesthesia. Root canal treatment of pulp disease and periapical disease is the most important method in general anesthesia. Dental caries filling and root canal therapy under general anesthesia can obtain the best therapeutic effect in children with non-cooperative children. There may be transient fever, malocclusion and other adverse reactions after operation.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R782.054

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