南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (4): 604-610.doi: 10.12122/j.issn.1673-4254.2023.04.14

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全麻与深度镇静下的儿童口腔治疗：家长接受度、口腔健康相关生活质量及疗效是否有差异？

冯青波，骆春梅，刘向红，许 婷，杜 芹   

  1. 电子科技大学附属医院//四川省人民医院口腔科，东院口腔科，麻醉科，四川 成都 610072
  • 出版日期:2023-04-20 发布日期:2023-05-16

General anesthesia versus deep sedation for dental treatment in children: comparison of parental acceptance, oral health-related quality of life, and treatment efficacy

FENG Qingbo, LUO Chunmei, LIU Xianghong, XU Ting, DU Qin   

  1. Department of Stomatology, Department of Stomatology of East Hospital, Department of Anesthesiology, Sichuan Provincial People's Hospital, Chengdu 610072, China
  • Online:2023-04-20 Published:2023-05-16

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摘要： 目的 比较口腔疾病患儿的家长对儿童口腔高级行为管理技术的接受度、比较接受全麻及深度镇静下口腔治疗患儿的治疗前后生活质量变化，并研究两种术式术后疗效差异。方法 对2022年1月~2022年6月在四川省人民医院口腔科就诊的131例患儿家长，进行儿童口腔高级行为管理技术的接受度问卷调查；对2018年1月~2021年12月在四川省人民医院口腔科接受全麻或深度镇静治疗的共83例患儿，进行术前术后生活质量对比问卷调查，比较术前术后生活质量得分；对2018年1月~2021年12月在四川省人民医院口腔科采取全麻或深度镇静手术治疗且1年后复诊的149例患儿，比较术后疗效。结果 儿童口腔高级行为管理技术的接受度问卷调查显示，62.6%的家长优先选择深度镇静麻醉方式，29.01%的家长优先选择全麻麻醉方式，8.4%的家长优先选择强制治疗的方式；全麻及深度镇静术后患儿口腔相关生活质量均得到显著性改善，两者间没有显著性差异。全麻术后患儿疼痛症状改善最为显著；深度镇静术后患儿疼痛症状和家长压力均明显改善。全麻及深度镇静术后1年复查，术后疗效没有显著性差异。结论 家长对深度镇静下儿童口腔疾病治疗的接受程度最高，其次接受全麻下儿童的口腔疾病治疗，对强制治疗的接受程度最低。经全麻及深度镇静口腔治疗后，患儿及家长的生活质量均得到显著改善。经全麻及深度镇静口腔治疗后，患儿均有良好的术后疗效。

关键词: 儿童口腔；全身麻醉；深度镇静；牙科恐惧症

Abstract: Objective To compare the parental acceptance of dental treatment under general anesthesia and deep sedation in children and assess the changes in postoperative oral health-related quality of life and treatment efficacy. Methods The parents of 131 children undergoing dental treatment in the Department of Stomatology of Sichuan Provincial People's Hospital from January, 2022 to June, 2022 were surveyed using a questionnaire of children's advanced oral behavior management, and 83 children receiving general anesthesia or deep sedation for dental treatment between January, 2018 and December, 2021 were also investigated for changes in quality of life after the treatment using a questionnaire. The treatment efficacy was assessed at the 1-year follow-up visit in 149 children who received dental treatment under general anesthesia or deep sedation during the same period. Results The survey of perantal acceptance showed that 62.6% of the parents preferred deep sedation, 29.01% preferred general anesthesia, and 8.4% preferred compulsory treatment. Dental treatments under general anesthesia and deep sedation both significantly improved oral health- related quality of life of the children. While dental surgeries under general anesthesia resulted in the most significant improvement of pain symptoms, deep sedation was associated with both obvious relief of the children's pain symptoms and reduction of the parents' pressure level. No significant difference was found in the efficacy of treatments under general anesthesia and deep sedation at the 1-year follow-up. Conclusion Dental treatment in children under deep sedation has the highest parental acceptance, followed by treatment under general anesthesia, and the acceptance of compulsory treatment is the lowest. The treatments under general anesthesia and deep sedation significantly improve the quality of life of the children and their parents and both have good treatment efficacy.

Key words: dental caries; general anesthesia; deep sedation; dental phobia