音樂療法在牙科焦慮癥患者阻生智齒拔除術(shù)中的應(yīng)用研究
發(fā)布時間：2018-11-25 10:16
【摘要】：[目的]通過流行病學(xué)調(diào)查,了解口腔頜面外科門診拔牙患者牙科焦慮癥的發(fā)病情況及流行程度,探討拔牙患者發(fā)生牙科焦慮癥可能相關(guān)的因素及觀察音樂療法在高度牙科焦慮癥患者阻生智齒拔除術(shù)中的臨床應(yīng)用效果。[方法]1 采用改良 Corah's 牙科焦慮量表(Modified dental anxiety scale,MDAS)及牙科焦慮一般因素調(diào)查表,評估800名12歲以上門診患者牙科焦慮癥的發(fā)生情況及流行程度,應(yīng)用單因素、多因素分析方法對調(diào)查對象的牙科焦慮癥狀及影響因素進行統(tǒng)計分析。2收集2016-2017年就診于我科,需行雙側(cè)對稱性下頜第三磨牙拔除的高度牙科焦慮癥患者25例,采用自身對照分組方式,第一次拔牙或第二次拔牙隨機完成音樂治療組或?qū)φ战M。實驗組采用局部麻醉下給予音樂療法輔助高速渦輪機拔除阻生智齒,對照組采用常規(guī)局部麻醉加高速渦輪機拔牙。分別記錄2組患者術(shù)前30分鐘、術(shù)前5分鐘、麻醉注射時、拔牙開始時、拔牙時、拔牙結(jié)束時、術(shù)后30min時的血壓、心率,并進行術(shù)后滿意度、術(shù)前與術(shù)后改良牙科焦慮量表評分。[結(jié)果]1剔除無效問卷后,得到合格問卷768份,有效率為96.13%.患者年齡12～91 歲,平均(30.76±15.59)歲;MDAS 分值 4—20 分,平均(10.21±3.29)分,MDAS≥13分為有高度牙科焦慮癥狀,其發(fā)生率為21.4%。性別、年齡分組、拔牙時間、親友陪伴、既往拔牙經(jīng)歷、親友拔牙經(jīng)歷、疼痛耐受度、精神狀態(tài)、健康狀況、拔牙前心理狀況、自評口腔衛(wèi)生狀況各組的牙科焦慮癥患病率差異有統(tǒng)計學(xué)意義(P0.05);文化程度、拔牙類型、民族、生活經(jīng)歷、是否喜歡聽音樂、性格、職業(yè)、是否初次拔牙差異沒有統(tǒng)計學(xué)意義(P0.05)。Logistic回歸分析顯示,性別、是否有親友陪伴、拔牙前心理狀況、自評口腔衛(wèi)生狀態(tài)對牙科焦慮癥的危險性較大。2在對照組中,經(jīng)過統(tǒng)計分析可知,術(shù)后30分鐘的收縮壓與拔牙開始時、拔牙時的收縮壓比較有統(tǒng)計學(xué)差異(P0.05);不同時間段的舒張壓比較無統(tǒng)計學(xué)差異(P0.05);術(shù)后30分鐘的心率與拔牙開始時、拔牙時的心率比較有統(tǒng)計學(xué)差異(P0.05);拔牙結(jié)束時的心率與拔牙開始時的心率比較有統(tǒng)計學(xué)差異(P0.05);拔牙開始時的心率與與術(shù)前5分鐘比較有統(tǒng)計學(xué)差異(P0.05);術(shù)前5分鐘與術(shù)前30分鐘收縮壓、舒張壓、心率均無統(tǒng)計學(xué)差異(P0.05)。在實驗組中,結(jié)束30分鐘的收縮壓與術(shù)前30分鐘、麻醉注射時、拔牙開始時、拔牙時的收縮壓比較有統(tǒng)計學(xué)差異(P0.05);術(shù)前5分鐘的收縮壓與術(shù)前30分鐘、麻醉注射時、拔牙開始時、拔牙時、拔牙結(jié)束時的比較有統(tǒng)計學(xué)差異(P0.05);結(jié)束30分鐘的舒張壓與拔牙開始時、拔牙時的舒張壓的比較有統(tǒng)計學(xué)差異(P0.05);拔牙開始時的舒張壓與術(shù)前5分鐘的比較有統(tǒng)計學(xué)差異(P0.05);結(jié)束30分鐘的心率與術(shù)前30分鐘、麻醉注射時、拔牙開始時、拔牙時的心率比較有統(tǒng)計學(xué)差異(P0.05);拔牙結(jié)束時的心率與麻醉注射時、拔牙開始時、拔牙時的心率比較有統(tǒng)計學(xué)差異(P0.05),術(shù)前5分鐘的心率與術(shù)前30分鐘、麻醉注射時、拔牙開始時、拔牙時的比較有統(tǒng)計學(xué)差異(P0.05)。實驗組與對照組各個時間段的收縮壓、舒張壓、心率均無統(tǒng)計學(xué)差異(P0.05)。實驗組患者就診滿意度高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。[結(jié)論]1口腔門診拔牙患者牙科焦慮癥發(fā)病率較高,應(yīng)給予重視。性別、年齡、拔牙時間、親友陪伴、既往拔牙經(jīng)歷、親友拔牙經(jīng)歷、疼痛耐受度、精神狀態(tài)、全身健康,、拔牙前心理狀況,口腔衛(wèi)生等是牙科焦慮癥的易發(fā)因素。2音樂療法在術(shù)前能減輕患者的焦慮狀態(tài),平穩(wěn)患者的收縮壓和心率。但在音樂療法配合高速渦輪機輔助拔除下頜阻生智齒過程中不能夠有效降低者的焦慮程度,平穩(wěn)患者的血壓和心率。3音樂療法輔助高速渦輪機拔除阻生智齒能明顯提高患者滿意度。
[Abstract]:[Objective] To investigate the incidence and prevalence of dental anxiety in patients with tooth extraction in oral and maxillofacial surgery by means of epidemiological investigation. To study the possible factors related to the occurrence of dental anxiety in the patients with tooth extraction and to observe the clinical application of the music therapy in the patients with high degree of dental anxiety.[Methods] 1 The incidence of dental anxiety and the prevalence of dental anxiety in the outpatients over 12 years of age were assessed by using the modified Corrah's Dental Anxiety Scale (MDAS) and the general factors of dental anxiety. a multi-factor analysis method was used to make a statistical analysis of the dental anxiety symptoms and the influencing factors of the investigated subjects. The music treatment group or control group was randomly completed for the first tooth extraction or the second extraction. The experimental group was given the music therapy with local anesthesia to assist the high-speed turbine to remove the retarded wisdom tooth, and the control group was extracted by conventional local anesthesia and high-speed turbine. The blood pressure, heart rate, postoperative satisfaction, pre-operative and post-operative improvement of the dental anxiety scale were recorded for 30 minutes before the operation and 5 minutes before the operation.[Results] After elimination of the invalid questionnaire, 768 parts of the qualified questionnaire were obtained, and the effective rate was 96.13%. The age of the patients was 12-91 years, the average (30. 76-15. 59) years, the MDAS score was 4-20, the average (10.21-3.29), and the MDAS-13 was divided into highly-dental anxiety symptoms, with a rate of 21.4%. There was a significant difference in the prevalence of dental anxiety in various groups (P0.05). The degree of culture, the type of tooth extraction, the nationality, the life experience, whether to listen to music, character, occupation, whether the initial tooth extraction difference is not statistically significant (P0.05). Logistic regression analysis shows that the gender, whether or not there is a friend and a family, the psychological condition before the tooth extraction, The risk of dental anxiety was higher in the self-evaluation of oral hygiene. In the control group, the systolic pressure of 30 minutes after operation and the start of tooth extraction were statistically different (P0.05). The results showed that the heart rate at the end of the tooth extraction and the heart rate at the beginning of the tooth extraction were statistically different (P0.05). The heart rate at the beginning of the extraction was significantly different from that in the first 5 minutes (P0.05); the systolic blood pressure, diastolic blood pressure and heart rate were not statistically different between the first 5 minutes and the first 30 minutes before the operation (P0.05). In the experimental group, the systolic blood pressure at the end of 30 minutes was 30 minutes before the operation, and at the time of the anesthesia injection, the systolic blood pressure at the time of extraction was statistically different (P0.05); the systolic blood pressure in the first 5 minutes before the operation was 30 minutes before the operation, and when the extraction was started, the tooth extraction was started, There was a statistical difference between the end of the tooth extraction (P0.05); the diastolic blood pressure at the end of the tooth extraction and the start of the tooth extraction were statistically different (P0.05); the diastolic blood pressure at the beginning of the tooth extraction was statistically different from that of the first 5 minutes (P0.05); At the end of the extraction, the heart rate at the end of the tooth extraction was statistically different (P0.05). The heart rate at the end of the tooth extraction and the time of the anesthesia injection, the heart rate at the end of the tooth extraction and the heart rate at the time of extraction were statistically different (P0.05). The heart rate of the first 5 minutes before the operation was 30 minutes before the operation, and at the time of the anesthesia, there was a statistically significant difference in the tooth extraction at the beginning of the tooth extraction (P0.05). The systolic and diastolic blood pressure and heart rate of the experimental group and the control group were not statistically different (P0.05). The degree of satisfaction of the patients in the experimental group was higher than that of the control group (P0.05).[Conclusion] The incidence of dental anxiety in the patients with tooth extraction in the first oral clinic is high, and attention should be paid to it. "Sex, age, tooth extraction time, companionship with relatives and friends, past tooth extraction experience, tooth extraction experience, pain tolerance, mental state, general health, pre-extraction psychological condition, oral hygiene and so on are the factors that are easy for dental anxiety. Music therapy can reduce the anxiety state of the patient before the operation," The systolic and heart rate of a stable patient. however, it is not effective to reduce that degree of anxiety and the blood pressure and the heart rate of the patient in the course of music therapy combined with the high-speed turbine to assist in the removal of the jaw-resistant wisdom tooth. the music therapy-assisted high-speed turbine's removal of the resistance-generating wisdom tooth can improve the patient's satisfaction.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.11
[Abstract]:[Objective] To investigate the incidence and prevalence of dental anxiety in patients with tooth extraction in oral and maxillofacial surgery by means of epidemiological investigation. To study the possible factors related to the occurrence of dental anxiety in the patients with tooth extraction and to observe the clinical application of the music therapy in the patients with high degree of dental anxiety.[Methods] 1 The incidence of dental anxiety and the prevalence of dental anxiety in the outpatients over 12 years of age were assessed by using the modified Corrah's Dental Anxiety Scale (MDAS) and the general factors of dental anxiety. a multi-factor analysis method was used to make a statistical analysis of the dental anxiety symptoms and the influencing factors of the investigated subjects. The music treatment group or control group was randomly completed for the first tooth extraction or the second extraction. The experimental group was given the music therapy with local anesthesia to assist the high-speed turbine to remove the retarded wisdom tooth, and the control group was extracted by conventional local anesthesia and high-speed turbine. The blood pressure, heart rate, postoperative satisfaction, pre-operative and post-operative improvement of the dental anxiety scale were recorded for 30 minutes before the operation and 5 minutes before the operation.[Results] After elimination of the invalid questionnaire, 768 parts of the qualified questionnaire were obtained, and the effective rate was 96.13%. The age of the patients was 12-91 years, the average (30. 76-15. 59) years, the MDAS score was 4-20, the average (10.21-3.29), and the MDAS-13 was divided into highly-dental anxiety symptoms, with a rate of 21.4%. There was a significant difference in the prevalence of dental anxiety in various groups (P0.05). The degree of culture, the type of tooth extraction, the nationality, the life experience, whether to listen to music, character, occupation, whether the initial tooth extraction difference is not statistically significant (P0.05). Logistic regression analysis shows that the gender, whether or not there is a friend and a family, the psychological condition before the tooth extraction, The risk of dental anxiety was higher in the self-evaluation of oral hygiene. In the control group, the systolic pressure of 30 minutes after operation and the start of tooth extraction were statistically different (P0.05). The results showed that the heart rate at the end of the tooth extraction and the heart rate at the beginning of the tooth extraction were statistically different (P0.05). The heart rate at the beginning of the extraction was significantly different from that in the first 5 minutes (P0.05); the systolic blood pressure, diastolic blood pressure and heart rate were not statistically different between the first 5 minutes and the first 30 minutes before the operation (P0.05). In the experimental group, the systolic blood pressure at the end of 30 minutes was 30 minutes before the operation, and at the time of the anesthesia injection, the systolic blood pressure at the time of extraction was statistically different (P0.05); the systolic blood pressure in the first 5 minutes before the operation was 30 minutes before the operation, and when the extraction was started, the tooth extraction was started, There was a statistical difference between the end of the tooth extraction (P0.05); the diastolic blood pressure at the end of the tooth extraction and the start of the tooth extraction were statistically different (P0.05); the diastolic blood pressure at the beginning of the tooth extraction was statistically different from that of the first 5 minutes (P0.05); At the end of the extraction, the heart rate at the end of the tooth extraction was statistically different (P0.05). The heart rate at the end of the tooth extraction and the time of the anesthesia injection, the heart rate at the end of the tooth extraction and the heart rate at the time of extraction were statistically different (P0.05). The heart rate of the first 5 minutes before the operation was 30 minutes before the operation, and at the time of the anesthesia, there was a statistically significant difference in the tooth extraction at the beginning of the tooth extraction (P0.05). The systolic and diastolic blood pressure and heart rate of the experimental group and the control group were not statistically different (P0.05). The degree of satisfaction of the patients in the experimental group was higher than that of the control group (P0.05).[Conclusion] The incidence of dental anxiety in the patients with tooth extraction in the first oral clinic is high, and attention should be paid to it. "Sex, age, tooth extraction time, companionship with relatives and friends, past tooth extraction experience, tooth extraction experience, pain tolerance, mental state, general health, pre-extraction psychological condition, oral hygiene and so on are the factors that are easy for dental anxiety. Music therapy can reduce the anxiety state of the patient before the operation," The systolic and heart rate of a stable patient. however, it is not effective to reduce that degree of anxiety and the blood pressure and the heart rate of the patient in the course of music therapy combined with the high-speed turbine to assist in the removal of the jaw-resistant wisdom tooth. the music therapy-assisted high-speed turbine's removal of the resistance-generating wisdom tooth can improve the patient's satisfaction.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R782.11
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