姜旋

[摘要]目的 探究持续冷敷和间断冷敷在下颌阻生智齿拔除术患者中的应用效果比较。方法 选取我院2018年11月～2019年7月拔出下颌阻生智齿的患者96例，采用随机数字表法分为持续组和间断组各48例，所有患者拔牙术后留院观察24 h，并予以常规护理。持续组在此基础上加用24 h持续冷敷处理，间断组在此基础上加用24 h间断冷敷处理。术后6、12、24 h分別测定两组患者面部肿胀程度、疼痛程度及局部皮肤温度。结果 术后6 h两组面部肿胀程度比较，差异无统计学意义（P>0.05）;持续组术后12、24 h面部肿胀程度低于间断组，差异均有统计学意义（P<0.05）。持续组术后6、12、24 h疼痛程度低于间断组，差异均有统计学意义（P<0.05）。持续组术后6、12、24 h皮温低于间断组，差异均有统计学意义（P<0.05）。结论 持续冷敷较间断冷敷更能改善患者下颌阻生智齿拔除后的面部皮温及肿胀程度，减轻患者疼痛程度，值得临床推广使用。

[关键词]持续冷敷;间断冷敷;下颌阻生智齿;治疗效果

[中图分类号] R781.05          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0062-04

Comparison of continuous cold compress and intermittent cold compress in extraction of impacted mandibular wisdom teeth

JIANG Xuan

Department of Stomatology Center， Xiangya Hospital of Central South University， Hu′nan Province， Changsha    410000， China

[Abstract] Objective To explore the effect of continuous cold compress and intermittent cold compress on the extraction of impacted mandibular wisdom teeth. Methods From November 2018 to July 2019， 96 patients with impacted mandibular wisdom teeth were selected and divided into continuous group and intermittent group， each had 48 cases. All patients were kept in hospital for 24 h after tooth extraction and received routine nursing. On this basis， the continuous group accepted 24 h continuous cold compress， and the intermittent group accepted 24 h intermittent nursing. The degree of facial swelling， the degree of pain and the local skin temperature were measured at 6， 12 and 24 hours after operation. Results There was no statistically significant difference in the degree of facial swelling between the two groups at 6 hours after surgery （P>0.05）; the degree of facial swelling at the 12 and 24 hours after surgery in the continuous group were lower than those in the intermittent group （P<0.05）. The pain levels in the continuous group were lower than those in the intermittent group at 6， 12， and 24 hours after operation， and the differences were statistically significant （P<0.05）. The skin temperature of the continuous group were lower than those of the intermittent group at 6， 12， and 24 hours after operation， and the differences were statistically significant （P<0.05）. Conclusion Compared with intermittent cold compress， continuous cold compress can improve the facial skin temperature and swelling degree of patients with impacted wisdom teeth after extraction， and reduce the pain degree of patients， which is worthy of clinical application.

[Key words] Continuous cold compress; Intermittent cold compress; Impacted mandibular wisdom teeth; Therapeutic effect

下颌阻生齿是指下颌部位由于软组织、邻牙或骨质阻碍导致牙齿不能萌出或者只能部分萌出[1]。下颌阻生牙最常见于第三磨牙，俗称智齿[2]。故下颌阻生智齿是一种临床上多发性疾病。下颌阻生智齿的解剖位置和结构形态多样，多位于咽喉壁，视野相对狭窄，拔牙操作难度较高，容易对周围软组织及深部骨组织造成损伤，因此术后并发症相对较多[3]。既往有学者统计发现，拔除下颌阻生智齿的患者中超过80%出现疼痛，其中剧烈疼痛者超过15%，拔除术后超过95%出现肿胀，特别严重的患者出现张口受限，言语功能障碍，甚至不能进食[4]。临床护理方案中对缓解术后肿胀疼痛最常见的有两种方法，包括持续冷敷和间断冷敷[5]。两种方法均能缓解术后疼痛程度，但目前国内少有相关文献证明两种护理方案效果的对比性研究。本研……