笑气吸入在咽反射敏感患者阻生齿拔除术中的应用

摘要

目的:观察笑气(N2O)吸入应用于咽反射敏感患者高、中位阻生齿拔除术的临床效果.方法:60例需拔除下颌高、中位近中阻生齿并伴咽反射敏感的患者,随机分为3组,每组20例(A组:N2O吸入组；B组:盐酸丁卡因胶浆涂抹组;C组:空白对照组).记录3组术前、术中、术后的血压(BP)、心率(HR)及血氧饱和度(SpO2),通过量表分析正常的操作触碰和高速涡轮牙钻喷水,对其咽部刺激、导致肌紧张程度、引起咽反射次数及耐受程度.结果:在整个手术过程中,A组BP、HR、SpO2变化平稳(P＞0.05)；B组术中和术后的BP、HR与术前比较有统计学意义；C组术中和术后的BP、HR与术前比较有统计学意义(P＜0.05),SpO2无明显变化(P＞0.05).实验组与对照组各项评定指标的比较均有统计学意义(P＜0.05).结论:笑气吸入在下颌阻生齿拔除过程中,可明显降低患者咽反射敏感性,安全可靠.%Objective:To investigate the clinical effects of nitrous oxide inhalation in extraction of high and medium positioned impacted teeth in pharyngeal sensitive patients. Methods: This retrospective study consisted of 60 patients and randomly divided into three groups: group A (n=20), nitrous oxide inhalation; group B (n=20), tetracaine hydrochloride mucilage daubing; and group C (n=20), the control group. BP, HR, and SpO2 of every case were recorded before operation , during the operation, and post-operation. Through the scale analysis, to compare the muscle tension, and the number of pharyngeal reflex and tolerance effected by routine operative contact to the pharyngeal wall and turbine spray stimulation, on pharyngeal wall. Results: During the operation process, HR, BP and SpO2 of group A patients smoothly changed (P>0.05). BP and HR of patients in the group B and C in perioperative and post-operative period, showed significant difference compared with preoperative period (P<0.05), but SpO2 differed slightly (P>0.05). The evaluation indicators of experimental and control groups manifested statistically significance (P<0.05). Conclusion: Nitrous oxide inhalation can safely used in extraction of mandibular impacted teeth in pharyngeal sensitivity patients.