陈丽

摘 要 目的：探讨良好的术前沟通对降低学龄前患儿牙科畏惧症发病的影响。方法：收集2015年1月至6月初次来中心口腔科就诊的160例学龄前患儿，分为干预组80例，术前进行良好的沟通，取得患儿信任后开展诊治；对照组80例，未进行有效沟通，直接进入诊疗环节。术后对两组进行畏惧症测评，并比较两组疗效。结果：干预组牙科畏惧症患儿31例，占38.7%；对照组67例，占83.7%，组间差异有统计学意义（P<0.05）。结论：良好的术前沟通可以明显降低学龄前患儿牙科畏惧症的发病。

关键词 牙科畏惧症 术前沟通 信任 无痛

中图分类号：R788 文献标志码：A 文章编号：1006-1533（2016）22-0044-03

Effect of the good preoperative communication in reducing the incidence of preschool children dental fear

CHEN Li（ Nianqiao Community Health Service Center of Fengxian District， Shanghai 201499， China）

ABSTRACT Objective： To investigate the effect of the good preoperative communication on the incidence of dental fear in preschool children. Methods： From January to June 2015， 160 cases of preschool children in the department of stomatology of our center were collected and divided into an intervention group with 80 cases and the good communication was developed before operation and after obtaining the trust of children the diagnosis and treatment were carried out. The control group had 80 cases， and the diagnosis and treatment were directly given to them without any effective communications. After operation， childrens fear of the two groups was evaluated， and the difference in efficacy between the two groups was compared. Results： The intervention group had 31 cases of dental fear， accounting for 38.7% and the control group had 67 cases of dental fear， accounting for 83.7%. The differences between the two groups had the statistical significance（P<0.05）. Conclusion： Good preoperative communication can significantly reduce the incidence of dental fear in preschool children.

KEY WORDS dental fear； preoperative communication； trust； painless

口腔疾病的诊疗门诊中，儿童口腔疾病的就诊率居高不下。由于家庭和社会对儿童口腔保健知识的欠缺，儿童牙龈炎，龋病，根尖周炎，乳牙滞留等疾病在门诊诊疗中屡见不鲜。在儿童牙病诊疗过程中，由于儿童对创伤特别敏感，理解力，自制力差，对诊疗的畏惧是一种相当普遍的现象。儿童牙科畏惧症（childrens dental fear，CDF），指患儿在牙科诊疗中所具有的紧张、害怕、忧郁的心理状态，以及在行为上表现出来的敏感性增高，耐受性降低，出现尖叫，抗拒或逃避行为的综合症候群[1]。各国的流行病学调查报道CDF发生率为 5%～80%，大大增加儿童牙医的工作压力和强度，对儿童牙病的准确诊断及彻底治疗均有较大影响，而且这种畏惧可延至成人期，导致成人牙科焦虑症。因此，帮助患儿摆脱畏惧心理，能够在心理不受创伤的前提下完成牙科治疗，针对其发病特点的分析与进行有效的应对措施是十分必要的。

1 对象与方法