中国实用口腔科杂志

中国实用口腔科杂志

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应用生存分析方法随访观察氟保护漆对学龄前儿童龋病的预防效果

缪羽，张双阳，于蕴之，姚丽英，曹欢   

  1. 内蒙古医科大学第四附属医院口腔科，内蒙古  包头  014030
  • 出版日期:2016-10-15 发布日期:2016-12-15
  • 基金资助:

    中华口腔医学会西部行口腔医学临床科研基金（CSA-W2013-06）

  • Online:2016-10-15 Published:2016-12-15

摘要：

目的    应用生存分析方法随访观察氟保护漆对学龄前儿童龋病的预防效果。方法    于2013年8月至2015年8月在包头市10所幼儿园随机选取3～5岁儿童330名作为随访研究对象。每一名从第一次入选开始为随访起点，记录其时间，并根据患儿家长自愿原则，其中215名给予乳牙涂氟保护漆+口腔卫生指导，其余115名仅给予口腔卫生指导。涂氟保护漆者每5个月实施1次，共计4次。每月见面随访1次，随访内容除两部分新患龋齿情况外，对年龄、性别、每日进零食次数等共计26项可能与新患龋病有关的因素予以观察记录。有失访者，记录其时间。在随访过程中若发现新发龋齿，为随访终点，记录其时间。到课题结束整理总结资料时还未出现新发龋齿为删失。所得资料以生存分析+COX多元回归分析。结果    排除进入模型的其他因素混杂作用后，每日进零食次数每增加1次，促进新发龋齿的危险是原来的1.072倍（RR = 1.072 > 1，其95%可信区间（CI）不包含1，P < 0.05），促进患病；含奶瓶入睡促进新发龋齿的危险是不含奶瓶入睡的3.846倍（RR = 3.846 >1，其95%CI不包含1，P < 0.05），亦促进患病；而乳牙涂氟保护漆促进新发龋齿的危险是不涂氟保护漆的0.412倍（RR = 0.412 < 1，其95%CI不包含1，P < 0.05），阻止患病。结论    每日增加进零食次数和含奶瓶入睡是学龄前儿童新发龋齿的危险因素，而乳牙涂氟保护漆为其保护因素。

关键词: 龋病, 学龄前儿童, 氟保护漆, 预防

Abstract:

Objective    To make follow-up observation on effect of fluor protector in prevention of dental caries in preschool children by the way of survival analysis. Methods    Three hundred and thirty 3-5 years old children were randomly selected from 10 kindergartens in Baotou from August 2013 to August 2015. The time of follow-up began from the first selection and record the time. According to the principle of being voluntary，215 of children were given fluor protector and oral hygiene instruction，and other 115 were given oral hygiene instruction only. Fluor protector application was done every 5 months for 4 times in all. Follow-up was done once a month. Observe and record the 26 factors related to the dental caries，such as age，gender，daily snack times and so on，then analyze the related factors. When someone was lost in follow-up，record the time. The ends of follow-up were the development of new caries. For those without new caries at the end of the study they were recorded censored. Analyze the related factors by survival analysis and COX multivariate regression analysis. Results    After exclusion of other factors involved in the model，each time increase of daily snack promoted the occurrence of dental caries by 1.072 of original（RR was 1.072 and the 95% confidence interval （CI） did not contain 1，P < 0.05）. Sleep with bottle in mouth promoted dental caries by 3.846 times（RR was 3.846 and the 95% CI did not contain 1，P < 0.05）. Risk of caries with fluor protector was 0.412 of that without fluor protector （RR was 0.412 and the 95% CI did not contain 1，P < 0.05）. Conclusion    Increasing snack times and going to sleep with bottle in mouth are the risk factors of dental caries of primary teeth，while application of fluor protector is the protective factor.

Key words: caries, preschool children, fluor protector, prevention