中国实用口腔科杂志

中国实用口腔科杂志 ›› 2023, Vol. 16 ›› Issue (5): 575-579.DOI: 10.19538/j.kq.2023.05.013

• 论著 • 上一篇    下一篇

全身麻醉下儿童口腔治疗术后不良反应的影响因素分析

范    晶，谷雅楠，赵金荣，林    梅   

  1. 首都医科大学附属北京朝阳医院口腔科，北京100020
  • 出版日期:2023-09-30 发布日期:2023-11-01

  • Online:2023-09-30 Published:2023-11-01

摘要： 目的    对儿童口腔全身麻醉（dental general anesthesia，DGA）治疗进行回顾性分析，探讨术后不良反应及其影响因素。方法    收集2021年1月至2023年1月于首都医科大学附属北京朝阳医院口腔科门诊全身麻醉下行舒适化口腔治疗的47例患儿病例资料，记录术后各项不良反应，包括有无哭闹、牙疼、口腔不适、情绪不稳易激惹、发热、牙龈渗血、咳嗽、口唇红肿等。选择性别、年龄、身体质量指数（BMI）、手术时长、总治疗牙数和既往治牙史作为影响因素进行统计分析。结果    ≤ 4岁组、BMI异常组、手术时长> 3 h组、总治疗牙数>10颗组患儿出现≥ 2种术后不良反应的发生率分别高于> 4岁组、BMI正常组、手术时长≤ 3 h组、总治疗牙数≤ 10颗组，差异均有统计学意义（均P < 0.05）。多因素logistic回归分析结果显示，年龄（OR = 3.967，95%CI：1.154 ~ 13.636，P = 0.029）、BMI（OR = 10.905，95%CI：1.192 ~ 95.921，P = 0.039）、总治疗牙数（OR = 19.460，95%CI：2.759 ~ 149.474，P = 0.004）、手术时长（OR = 9.098，95%CI：1.045 ~ 57.984，P = 0.046）是DGA术后发生≥ 2种不良反应的独立危险因素。口腔不适、牙龈渗血、哭闹在患儿DGA术后不良反应中发生率较高。结论   年龄、BMI、总治疗牙数、手术时间是儿童DGA术后不良反应的独立危险因素，为进一步完善儿童DGA治疗提供临床依据。

关键词: 儿童, 口腔全身麻醉, 术后不良反应

Abstract: Objective    To perform a retrospective analysis of dental general anesthesia（DGA） in children to explore postoperative adverse reactions and influencing factors. Methods    The data of 47 cases of children treated under general anesthesia in the outpatient clinic of Department of Stomatology，Beijing Chao-yang Hospital，Capital Medical University from January 2021 to January 2023 were collected，and postoperative adverse reactions were recorded，including crying，toothache，oral discomfort，emotional instability，irritability，fever，gingival bleeding，cough，and lip redness and swelling. Gender，age，body mass index（BMI），surgical duration，total number of treated teeth，and previous dental history were selected as influencing factors for statistical analysis. Results    The incidence of ≥ 2 postoperative adverse reactions of the age ≤ 4 year old group，abnormal BMI group，operation time > 3 h group，and total treated teeth > 10 group was higher than the age > 4 year group，normal BMI group，operation time ≤ 3 h group and total treated teeth ≤ 10 group，and the differences were statistically significant（all P < 0.05）. Multivariate logistic regression analysis showed that age（OR = 3.967，95%CI：1.154 - 13.636，P = 0.029），BMI（OR = 10.905，95%CI：1.192 - 95.921，P = 0.039），total number of teeth treated（OR = 19.460，95%CI：2.759 - 149.474，P = 0.004），and operation duration（OR = 9.098，95%CI：1.045 - 57.984，P = 0.046）were independent risk factors for more than two adverse reactions after DGA. Oral discomfort，gingival bleeding，and crying were more common in adverse reactions after DGA in children. Conclusion    Age，BMI，total number of treated teeth and surgical time are independent risk factors for adverse reactions after pediatric general anesthesia surgery. This study provides clinical basis for further improving DGA in children. 

Key words: children, dental general anesthesia, postoperative adverse reactions