目的：观察阿替卡因肾上腺素黏膜下浸润麻醉对慢性牙周炎患者龈下刮治和根面平整（ scaling and root planning， SRP）的效果和依从性的影响。方法：选取中、重度慢性牙周炎患者38例，共68个探诊出血，牙周袋探诊深度（ probing depth，PD）>4 mm，临床附着丧失（ clinical attachment loss，CAL）≥3 mm的位点，将其分为局部麻醉组19例，共36个位点，对照组19人，共32个位点。观察治疗前后牙周临床指标牙龈指数（ gingival index，GI），PD和CAL的变化，记录患者治疗中的VAS值，以及治疗后3月和6月的失访率。结果：治疗前，两组各临床指标均差异无统计学意义（ P>0.05）。治疗后1月，两组GI和PD均明显降低（P﹤0.05），CAL差异无统计学意义（P>0.05），两组间各临床指标均差异无统计学意义（P>0.05）。局部麻醉组VAS值明显低于对照组（P﹤0.05），治疗后6月，局部麻醉组的失访率也明显低于最照组（P﹤0.05）。结论：局部麻醉能充分缓解患者SRP治疗过程中的疼痛不适感，避免患者对治疗的恐惧和排斥，增强长期就诊的依从性。%Objective To observe the effects of local anaesthesia on scaling and root planning( SRP)and compliance of chronic peri-odontitis patients. Method 68 target sites from 38 patients with chronic periodontitis probing depth( PD)>4 mm,clinical attachment loss ( CAL)≥3 mm were selected. 68 sites were divided into two groups( local anaesthesia group and control group). SRP was given to both groups. The data of clinical indices were collected before and after therapy. Results Before SRP,there were no significant differences be-tween two groups( P>0. 05). 1 month after SRP,GI( gingival index,)and PD in both groups decreased significantly compared with those at baseline(P﹤0. 05),but there were still no significant differences between two groups(P>0. 05). Moreover,visual analogue scale(VAS) in local anaesthesia group was significantly lower than that in control group(P﹤0. 05). 6 months after SRP,the loss ratio of follow-up in local anaesthesia group was significantly lower than that control group( P﹤0. 05 ). Conclusion Local anaesthesia played an important role in the relief of pain,which might contribute to improve compliance of chronic periodontitis patients.
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