不同高血压分级患者急性牙髓炎开髓治疗的风险评估

发布时间：2018-04-09 18:26

本文选题：高血压　切入点：牙髓炎　出处：《北京大学学报(医学版)》2016年01期

【摘要】：目的:评估不同高血压分级患者治疗急性牙髓炎过程中的生命体征变化和影响因素,以获得风险预防措施。方法:纳入2014年2月至2015年2月间就诊于北京大学口腔医院急诊科的不同高血压分级的急性牙髓炎患者90例,收集患者的全身健康状况、口腔治疗情况、生命体征的变化等信息,根据高血压患者的心脑血管风险评估分型,把纳入研究的患者分为牙髓炎治疗的低危组、中危组和高危组各30例。结果:(1)与术前相比,高危组术中收缩压升高、舒张压升高、心率增快的比例都在80%以上(分别为90%、80%、100%),中危组和低危组各项指标升高的比例明显低于高危组,差异有统计学意义(P0.01);同时,高危组超过1/4(26.7%)的患者收缩压增幅大于20 mm Hg(1 mm Hg=0.133 k Pa),2/5的患者舒张压增幅大于10 mm Hg,与中危组和低危组相比差异有统计学意义(P0.05)。(2)与术前相比,高危组术中收缩压和舒张压变化的最大峰值均增高,收缩压增高(18.0±1.5)mm Hg,舒张压增高(8.0±1.7)mm Hg,心率变化均值也增加了(7.0±0.3)次/min,而低危组和中危组这两项指标均下降;高危组有6例在治疗过程中出现心电图改变,低危组和中危组则无明显改变。(3)术前初评、术后终评的风险评估对比发现,中危组患者在术后被评价为中等危险的有23例,6例被评价为低等危险,1例为高等危险(风险评级增加);高危组术后被评价为高等危险的有20例,7例被评价为极高危险,3例为中等危险(风险评级降低)。结论:口腔治疗对于高血压患者来说是非常安全的,但危险因素、靶器官受损及并发症也会增加高血压患者在治疗过程中出现心血管意外的风险,因此应该采取一定措施来规避风险。
[Abstract]:Objective: to evaluate the changes of vital signs and influencing factors during the treatment of acute pulpitis in patients with different grades of hypertension.Methods: from February 2014 to February 2015, 90 patients with acute pulpitis with different grades of hypertension were enrolled in the emergency department of Peking University Stomatology Hospital. The patients' general health status and oral treatment were collected.According to the cardiovascular and cerebrovascular risk assessment of hypertensive patients, the patients included in the study were divided into three groups: low risk group, middle risk group and high risk group.At the same time, the increase of systolic blood pressure in patients with high risk group was more than 20 mm Hg(1 mm Hg=0.133 k Pax 2 / 5, which was more than 10 mm Hg, which was significantly higher than that in moderate and low risk group.The peak values of systolic and diastolic blood pressure in high risk group were all increased, systolic blood pressure increased by 18.0 卤1.5)mm Hg, diastolic blood pressure increased by 8.0 卤1.7)mm Hg, and the mean heart rate increased by 7.0 卤0.3 times / min, but both in low risk group and moderate risk group decreased.In high risk group, electrocardiogram changes occurred in 6 cases during treatment, but no significant change was found in low risk group and moderate risk group.Of the 23 patients in the moderate risk group who were evaluated as moderate risk after operation, 6 were evaluated as low risk and 1 as high risk (increased risk rating), while 20 patients in high risk group were evaluated as high risk after operation. 7 patients with high risk were evaluated as extremely highThere were 3 cases of moderate risk (lower risk rating).Conclusion: oral treatment is very safe for patients with hypertension, but risk factors, target organ damage and complications also increase the risk of cardiovascular accidents in patients with hypertension.Therefore, certain measures should be taken to avoid risks.
【作者单位】：北京大学口腔医学院·口腔医院急诊科;
【分类号】：R544.1;R781.31

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