艾喜婷++韩威利

【摘要】 目的：评价七氟醚吸入麻醉应用于口腔科儿童恐惧症患儿临床治疗效果。方法：64例被诊断为牙科恐惧症的患儿按年龄分为学龄前组（n=34）和学龄组（n=30），两组患儿在七氟醚吸入麻醉下开展滞留乳牙拔除、根管治疗和龋齿填充治疗。记录两组患儿吸入麻醉诱导和苏醒情况；比较两组患儿麻醉过程中平均动脉压和血氧饱和度变化情况；记录两组患儿麻醉过程中不良反应发生情况。结果：所有患儿均在七氟醚吸入麻醉下顺利完成口腔疾病治疗。两组吸入麻醉诱导时意识消失时间、疼痛反应消失时间和睫毛反射消失时间比较差异均无统计学意义（P>0.05）；两组苏醒时意识恢复时间比较差异无统计学意义（P>0.05）；两组吸入前、吸入后和治疗中血氧饱和度和平均动脉压差异比较差异均无统计学意义（P>0.05）；两组恶心呕吐和躁动伴恶心呕吐发生率比较差异无统计学意义（P>0.05），学龄前组躁动发生率高于学龄组（P<0.05）。结论：七氟醚吸入麻醉应用于牙科恐惧症患儿口腔疾患治疗安全有效，对呼吸和血流动力学影响较小，术后并发症较少，值得临床推广应用。

【关键词】 口腔科； 牙科恐惧症； 七氟醚； 麻醉； 效果

Analysis on the Application Effects of Sevoflurane Inhalation Anesthesia in Children Phobia in Dentistry/AI Xi-ting，HAN Wei-li.//Medical Innovation of China，2014，11（16）：025-027

【Abstract】 Objective：To investigate the application effects of sevoflurane inhalation anesthesia in children phobia in dentistry.Method：64 patients diagnosed as dental phobia were divided into preschool group and school-age group. Stranded deciduous unplug， root canal therapy and dental caries filling were carried under sevoflurane anesthesia in the two groups. Inhalation anesthesia induction and emergence situation were recorded in the two groups. The mean arterial pressure and oxygen saturation changes during anesthesia were compared between the two groups. Adverse events during anesthesia were recorded. Result：All patients were successfully complete treatment of oral diseases under sevoflurane anesthesia. When inhalation anesthesia induction， the differences of loss of consciousness time， the pain disappeared reaction time and eyelash reflex time between the two groups were not statistically significant （P>0.05）. When waking， the consciousness recovery times between the two groups were not statistically significant （P>0.05）. Before inhalation， after inhalation and during therapy， the differences of oxygen saturation and mean arterial pressure between the two groups were not statistically significant （P>0.05）. The incidences of nausea and vomiting and restlessness associated with nausea and vomiting were no significant difference （P>0.05）. The incidence of restless in the preschool group was higher than the school-age group （P<0.05）.Conclusion：Sevoflurane anesthesia used in treatment of oral diseases in children with dental phobia was safe and effective. It had less impact on the respiratory and hemodynamic， and fewer postoperative complications. It is worthy of clinical application.

【Key words】 Dentistry； Dental phobia； Sevoflurane； Anesthesia； Effect

First-authors address：The Central Hospital of Xinxiang City， Xinxiang 453000，China

doi：10.3969/j.issn.1674-4985.2014.16.008

儿童由于缺少良好的生活习惯，加之喜食甜食，很容易使牙齿遭受破坏，而不得不进行拔牙、根管治疗等，但在口腔疾病诊疗过程中，由于震动和疼痛等容易使患儿产生紧张、害怕和恐惧心理，临床上称“牙科恐惧症”[1]。该症状在临床上极为常见，造成患儿对诊疗过程的不配合，不仅给治疗带来困难，而且给疾病治疗效果带来不良影响。临床上常采取按压、捆绑的方式强行对患儿进行治疗，但是这些方法会增加患儿恐惧心理，而且在诊疗中还可能造成口腔其他损伤[2-3]。因此，积……