老年心血管疾病患者监护拔牙的安全性分析

发布时间：2018-05-27 05:20

本文选题：老年人 + 心血管疾病　；参考：《上海交通大学》2014年硕士论文

【摘要】：目的：分析老年心血管疾病患者监护拔牙的安全性。方法：选取2008-2012年上海交通大学医学院附属第九人民医院心血拔牙门诊就诊的13527例患者的调查资料，对其年龄、性别构成比和所患疾病的种类等进行比较研究；通过对7077例老年高血压或合并其他慢性疾病的患者进行全程心电监护下拔牙，分析各因素对拔牙风险性的影响；随机选取有原发性高血压的C组患者，对其拔牙过程进行心电图或Holter记录，比较两种检测方法对心血管事件的检出率。结果：（1）该门诊就诊人群以老年人为主（75.3%），70-79岁为就诊高峰年龄段；所患疾病以高血压、冠心病、心律失常、脑血管意外、糖尿病等为主。（2）老年高血压患者拔牙安全性分析中，对各个年龄层、性别、以及不同合并疾病进行分组比较，，各组间不同时间点的收缩压存在显著性。性别不同在心率变化上有显著差别。（3） Holter对拔牙过程中心血管事件的检出率明显高于普通心电图，两者间有统计学差异。结论：（1）该门诊以老年高血压患者为主，其次冠心病、心律失常等。（2）年龄的增加、多种疾病的并存加大了拔牙风险；运用危险性评分能快速判断拔牙风险性。（3） Holter在检出率方面比普通心电图更优秀，可在高危拔牙人群中推广。
[Abstract]:Objective: to analyze the safety of dental extraction in elderly patients with cardiovascular disease. Methods: from 2008 to 2012, the data of 13527 patients who were treated in the outpatient department of heart blood extraction in the Ninth people's Hospital affiliated to Shanghai Jiaotong University Medical College were investigated, and their age, sex composition ratio and kinds of diseases were compared and studied. The effects of various factors on the risk of tooth extraction were analyzed in 7077 elderly patients with hypertension or other chronic diseases by electrocardiographic monitoring, and the patients in group C with essential hypertension were randomly selected. Electrocardiogram (ECG) or Holter were recorded during tooth extraction, and the detection rate of cardiovascular events was compared between the two methods. Results (1) the peak age of the outpatient was 75.3% and 70-79 years old, and the main diseases were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, diabetes mellitus and so on, and the main diseases were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, diabetes mellitus and so on. 2) in the analysis of the safety of tooth extraction in elderly patients with hypertension, the systolic blood pressure at different time points was significant in different age groups, sex and complicated diseases. Gender differences have significant differences in heart rate changes. 3) the detection rate of cardiovascular events in tooth extraction by Holter was significantly higher than that in normal electrocardiogram (ECG), and there was statistical difference between them. Conclusion (1) the outpatient was mainly elderly patients with hypertension, followed by coronary heart disease, arrhythmia and so on. 2) with the increase of age and the coexistence of many diseases, the risk of extraction is increased, and the risk of extraction can be judged quickly by using the risk score. (3) Holter is better in detecting rate than general ECG, and can be popularized in high risk population of tooth extraction.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R54;R782.11

【参考文献】