张文静 陈旭霞

摘 要 目的：探讨心理干预在学龄儿童窝沟封闭术中应用的效果。方法：用随机整群抽样方法抽取符合窝沟封闭条件的二年级学龄儿童100例，其中男性48名，女生52名；随机分为干预组和对照组，分别采用心理干预和常规治疗方法进行窝沟封闭术。观察两组儿童合作程度及半年后封闭剂保留率。结果：治疗过程中，干预组儿童的合作程度明显高于对照组（Ⅰ级38.0%，II级50.0%，Ⅲ级12.0%；比I级16.0%，II级14%，Ⅲ级70.0%；P<0.01）。治疗6个月后，干预组窝沟封闭剂保留率高于对照组（完全保留87.5%，部分脱落8.5%，完全脱落3.9%；比完全保留60.2%，部分脱落20.5%，完全脱落19.1%；P<0.01）。结论：心理干预是保证学龄儿童窝沟封闭治疗效果的有效方法。

关键词 龋齿；心理干预；学龄儿童；窝沟封闭术

中图分类号：R788.1 文献标志码：A 文章编号：1006-1533（2021）02-0051-03

Application effect of psychological intervention in pit and fissure sealing operation in school-age children

ZHANG Wenjing， CHEN Xuxia（Nursing Department of Baiyun Community Health Service Center of Yuexiu District， Guangzhou， Guangdong 510100， China）

ABSTRACT Objective： To explore the application effect of psychological intervention in pit and fissure sealing operation in school-age children. Methods： A random cluster sampling method was used to select 100 school-age children in secondgrade who met the pit and fissure sealing conditions， including 48 males and 52 girls； they were randomly divided into an intervention group and a control group， and psychological intervention and conventional treatment were used for pit and fissure sealing， respectively. The degree of cooperation between the two groups of children and the retention rate of the sealant after six months were observed. Results： During the course of treatment， the cooperation degree of children in the intervention group was significantly higher than that in the control group （38.0% for grade I， 50.0% for grade II， 12.0% for grade III； 16.0% for grade I， 14% for grade II， and 70.0% for grade III； P<0.01 ）. After 6 months of treatment， the retention rate of pit and fissure sealant in the intervention group was higher than that in the control group（87.5% completely retained， 8.5% partially lost， and 3.9% completely lost； the completely retention rate， the partly rate and completely losing rate of sealant were 60.2%， 20.5% and 19.1%. Conclusion： Psychological intervention is an effective method to ensure the effect of pit and fissure sealing treatment in schoolage children.

KEY WORDS dental caries， psychological intervention； school-age children， pit and fissure sealing

齲病属于细菌感染性疾病，是细菌在多种因素的作用下对牙齿硬组织产生的一种慢性、破坏性、进行性的常见疾病[1]，影响着儿童的身体健康和生长发育。全国第三次口腔健康流行病学调查结果表明，5岁儿童乳牙龋病的患病率为66.0%，12岁儿童恒牙龋病的患病率为28.9%[2]。窝沟封闭又称点隙裂沟封闭，是一种能有效增强发育时期儿童牙齿抗龋能力的技术，是将高分子复合树脂材料涂在儿童牙齿窝沟内，液态的树脂在进入窝沟后固化变硬，形成一层保护性的屏障，阻止致龋菌及酸性代谢产物对牙体的侵蚀，从而预防龋病[3]。儿童通常缺乏良好的协作性和控制力，大多数儿童对牙科操作有恐惧心理，容易出现过激的情绪反应，是治疗过程中的一大障碍。因此，对儿童进行具体的心理状态评估，有针对性地实施心理干预来消除患儿的恐惧心理，提高配合程度，在治疗过程中显得十分重要。……