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中华老年病研究电子杂志

中华老年病研究电子杂志 ›› 2020, Vol. 07 ›› Issue (01) : 36 -40. doi: 10.3877/cma.j.issn.2095-8757.2020.01.009

所属专题： 文献；

临床研究

STA无痛麻醉仪结合超声骨刀在抗凝血治疗老年人残根拔除术中的应用
肖佳灵1, 徐国超1,†()   
  1. 1. 310030　杭州，浙江医院口腔科
  • 收稿日期:2019-12-02 出版日期:2020-02-28
  • 通信作者: 徐国超
  • 基金资助:
    浙江省自然科学基金探索项目(LQ20H140003)

Application of STA painless anaesthesia combined with piezosurgery in anticoagulated elderly patients requiring residual root extraction

Jialing Xiao1, Guochao Xu1,†()   

  1. 1. Department of Stomatology, Zhejiang Hospital, Hangzhou 310030, China
  • Received:2019-12-02 Published:2020-02-28
  • Corresponding author: Guochao Xu
  • About author:
    Corresponding author: Xu Guochao, Email:
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肖佳灵, 徐国超. STA无痛麻醉仪结合超声骨刀在抗凝血治疗老年人残根拔除术中的应用[J]. 中华老年病研究电子杂志, 2020, 07(01): 36-40.

Jialing Xiao, Guochao Xu. Application of STA painless anaesthesia combined with piezosurgery in anticoagulated elderly patients requiring residual root extraction[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2020, 07(01): 36-40.

目的

探讨STA无痛麻醉仪结合超声骨刀用于长期抗凝血药物治疗老年人残根拔除的临床效果。

方法

选取2018年6月至2019年9月在浙江医院行残根拔出的老年患者60例，其中30例采用STA无痛麻醉结合超声骨刀行微创拔牙（观察组），另30例采用传统卡局式注射器麻醉配合高速涡轮机与牙挺拔牙（对照组）。比较两组患者麻醉及拔牙过程中的VAS疼痛评分和麻醉前、麻醉后30 s、拔牙开始5 min、拔牙后30 min的血压和心率，以及拔牙时间、术中出血量、术后30 min的止血情况。组间计量的比较采用秩和检验、重复测量方差分析及t检验，率的比较采用χ2检验。

结果

两组患者残根均完整拔除。观察组麻醉VAS评分明显低于对照组（z=-2.462，P<0.05），拔牙VAS评分的差异无统计学意义（z=-1.802，P>0.05）。两组患者各时点收缩压、舒张压及心率的差异均无统计学意义（F=2.500、0.014、3.001，均P>0.05），但观察组拔牙时间及术中出血量均明少于对照组（t=2.553、-6.368，P<0.05或0.01）。两组患者拔牙30 min后，观察组止血效果亦明显优于对照组（χ2=5.450，P<0.05）。

结论

对于长期抗凝血治疗的老年人，采用STA无痛麻醉仪配合超声骨刀进行拔牙术，可明显减轻术中疼痛程度和血压波动，且术中、术后止血情况良好。

关键词: STA无痛麻醉仪, 抗凝血治疗, 超声骨刀, 老年患者, 拔牙术
Objective

To investigate the clinical effect of STA painless anaesthesia combined with piezosurgery in anticoagulated elderly patients requiring residual root extraction.

Methods

60 elderly patients with residual root extraction in Zhejiang hospital from June 2018 to September 2019 were selected. Among them, 30 patients were treated with STA painless anesthesia combined with piezosurgery for minimally invasive tooth extraction (observation group), 30 patients were treated with traditional card local syringe anesthesia combined with high-speed turbine and tooth extraction (contrast group). The VAS pain score, blood pressure and heart rate before anesthesia, 30 s after anesthesia, 5 min after extraction and 30 min after extraction were compared between the two groups, as well as extraction time, intraoperative bleeding volume and hemostasis 30 min after operation. The rank sum test, repeated ANOVA and t test were used for the comparison between groups, and the chi-square test was used for the comparison of rates.

Results

The residual roots of all patients were completely removed. The anesthesia VAS score in the observation group was significantly lower than that in the control group (z=-2.462, P < 0.05), and the difference in tooth extraction VAS score was not statistically significant (z=-1.802, P > 0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate at each time point between the two groups (F=2.500, 0.014, 3.001, P > 0.05), but the extraction time and intraoperative bleeding in the observation group were significantly shorter than those in the control group (t=2.553, -6.368, P < 0.05 or 0.01). The hemostasis effect of the observation group was better than that of the control group (χ2= 5.450, P < 0.05).

Conclusion

For the elderly patients with long-term anticoagulant treatment, the use of sta painless anesthesia instrument combined with piezosurgery for tooth extraction can significantly reduce the degree of pain and blood pressure fluctuations during the operation, and the hemostasis is good during and after the operation.

Key words: Painless STA, Anticoagulation therapy, Piezosurgery device, Elderly patients, Tooth extraction
表1 两组患者血压、心率、拔牙时间及术中出血量的比较
组别 例数 收缩压（mmHg） 舒张压（mmHg）
t1 t2 t3 t4 t1 t2 t3 t4
观察组 30 127.5±8.2 127.8±8.9 127.3±6.8 124.3±5.5 78.5±4.7 79.1±5.9 77.6±4.9 79.4±8.1
对照组 30 129.5±4.4 134.5±9.8 126.8±5.3 125.7±6.2 77.9±4.9 79.0±6.8 82.4±5.9 75.9±7.0
检验值 ? F=2.500 F=0.014
P值 ? >0.05 >0.05
组别 例数 心率（次/min） 拔牙时间（min） 术中出血量（ml）
t1 t2 t3 t4
观察组 30 82.2±6.8 82.0±8.3 82.7±5.0 79.5±4.2 11.2±2.0 2.9±0.9
对照组 30 80.2±6.1 88.7±8.0 85.6±5.5 80.4±3.4 9.9±1.9 4.7±1.4
检验值 ? F=3.001 t=2.553 t=-6.368
P值 ? >0.05 <0.05 <0.01
表2 两组患者拔牙后30 min止血情况的比较[例（%）]
组别 例数 止血 未止血
观察组 30 26（86.7） 4（3.3）
对照组 30 18（60.0） 12（40.0）
χ2值 ? 5.450
P值 ? <0.05
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