本文關(guān)鍵詞：阻滯麻醉、浸潤麻醉以及補充牙周韌帶麻醉在下頜后牙麻醉效果比較　出處：《山東大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 阻滯麻醉 浸潤麻醉 牙周韌帶麻醉 牙髓炎

【摘要】：研究目的比較阻滯麻醉、浸潤麻醉以及補充牙周韌帶麻醉在下頜后牙不可逆性牙髓炎中麻醉效果。材料與方法收集2016年2月至2017年4月期間在山東大學口腔醫(yī)院治療的下頜后牙不可逆性牙髓炎患者140名,排除不符合條件者,最終納入實驗者130名,男性57名,女性73名,年齡在18-65歲,下頜第一磨牙39顆,下頜第二磨牙64顆,下頜前磨牙27顆。采用隨機分組的方法將130名患者隨機分為A、B兩組。A組采用2%鹽酸利多卡因注射液行下齒槽、頰、舌阻滯麻醉,B組采用4%阿替卡因腎上腺素注射液(必蘭)行頰、舌側(cè)浸潤麻醉。記錄患者注射麻藥前冷熱診、注射麻藥后冷熱診以及治療過程中的VAS值。中度或者重度疼痛者則使用4%阿替卡因腎上腺素注射液(必蘭)補充牙周韌帶麻醉(AS組與BS組)。在開髓、拔髓、根管預(yù)備過程中無痛或者輕度疼痛被視為麻醉成功。比較各組間的麻醉成功率。統(tǒng)計結(jié)果使用SPSS22.0軟件進行fisher檢驗。結(jié)果補充麻醉前A組麻醉成功率:第一磨牙44.4%、第二磨牙38.9%、前磨牙45.5%;B組麻醉成功率:第一磨牙47.6%、第二磨牙39.3%、前磨牙87.5%。補充麻醉后A組麻醉成功率:第一磨牙83.3%、第二磨牙91.7%、前磨牙100%;B組麻醉成功率:第一磨牙90.5%、第二磨牙92.9%、前磨牙100%。補充麻醉前兩組間麻醉成功率在磨牙無統(tǒng)計學差異(P0.05);但是在前磨牙麻醉成功率浸潤麻醉高于阻滯麻醉,其差異有統(tǒng)計學意義(p0.05);A組前磨牙麻醉成功率與磨牙麻醉成功率無統(tǒng)計學差異,但是B組前磨牙麻醉成功率高于磨牙麻醉成功率,其差異有統(tǒng)計學意義(p0.05)。補充麻醉后兩組間的差異在磨牙、前磨牙均無統(tǒng)計學意義,但是補充麻醉后第一磨牙、第二磨牙的麻醉成功率在A、B兩組均高于未補充麻醉前,差異具有統(tǒng)計學意義(p0.05)。結(jié)論下頜磨牙不可逆性牙髓炎患者使用兩種麻醉方法可以取得相似的成功率,但是下頜前磨牙患者浸潤麻醉可以取得比阻滯麻醉更高的成功率。前磨牙浸潤麻醉成功率高于磨牙浸潤麻醉。補充牙周韌帶麻醉可以提高下頜磨牙的麻醉成功率。
[Abstract]:Objective to compare block anesthesia. The anesthetic effect of invasive anesthesia and periodontal ligament replacement anesthesia in the treatment of irreversible pulpitis of mandibular posterior teeth. Materials and methods collected from February 2016 to April 2017 in the Stomatology Hospital of Shandong University. 140 patients with posterior irreversibility pulpitis. There were 130 subjects (57 males and 73 females), aged 18-65 years, with 39 first molars and 64 second molars. Twenty seven mandibular premolars were randomly divided into two groups. Group A was treated with 2% lidocaine hydrochloride injection under lower alveolar, buccal and tongue block anesthesia. Group B was treated with 4% Atevacaine epinephrine injection (Bi-lan) under buccal and lingual infiltration anesthesia. VAS value of cold and hot diagnosis and treatment after injection of anesthetic. Patients with moderate or severe pain were treated with 4% Atevacaine epinephrine injection (Beilan) to supplement periodontal ligament anesthesia group as and BS group). Open the marrow. Pulping. Painless or mild pain during root canal preparation was regarded as successful anaesthesia. The success rate of anesthesia was compared among groups. The statistical results were tested by fisher using SPSS22.0 software. Success rate of anesthesia:. First molar 44.4%. The second molar was 38.9 and the premolar was 45.5; The success rate of anesthesia in group B was 47.6 for the first molar, 39.3 for the second molar and 87.5for the premolar. After supplementary anesthesia, the success rate of anesthesia in group A was 83.3 for the first molar and 91.7% for the second molar. 100 parts of premolars; The success rate of anesthesia in group B was 90.5 for the first molar, 92.9 for the second molar and 100 for the premolar. There was no significant difference in the success rate of anesthesia between the two groups before supplementary anesthesia (P 0.05). But the success rate of invasive anesthesia in premolar was higher than that of block anesthesia, and the difference was statistically significant (P 0.05). There was no statistical difference between the success rate of premolar anesthesia and that of molar anesthesia in group A, but the success rate of premolar anesthesia in group B was higher than that of molar anesthesia. After supplementary anesthesia, the difference between the two groups was not statistically significant in molar and premolar, but the success rate of first molar and second molar after supplementary anesthesia was in A. The difference between group B and group B was statistically significant (P 0.05). Conclusion the two anesthesia methods can achieve similar success rate in patients with irreversible pulpitis of mandibular molars. The success rate of premolar infiltration anesthesia is higher than that of mandibular premolar infiltration anesthesia, and that of mandibular premolar infiltration anesthesia is higher than that of molar infiltration anesthesia, and the rate of mandibular molar anesthesia can be improved by supplementing periodontal ligament anesthesia. .
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R782.054

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