阻滞麻醉、浸润麻醉以及补充牙周韧带麻醉在下颌后牙麻醉效果比较

发布时间：2018-01-15 02:32

本文关键词：阻滞麻醉、浸润麻醉以及补充牙周韧带麻醉在下颌后牙麻醉效果比较　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的比较阻滞麻醉、浸润麻醉以及补充牙周韧带麻醉在下颌后牙不可逆性牙髓炎中麻醉效果。材料与方法收集2016年2月至2017年4月期间在山东大学口腔医院治疗的下颌后牙不可逆性牙髓炎患者140名,排除不符合条件者,最终纳入实验者130名,男性57名,女性73名,年龄在18-65岁,下颌第一磨牙39颗,下颌第二磨牙64颗,下颌前磨牙27颗。采用随机分组的方法将130名患者随机分为A、B两组。A组采用2%盐酸利多卡因注射液行下齿槽、颊、舌阻滞麻醉,B组采用4%阿替卡因肾上腺素注射液(必兰)行颊、舌侧浸润麻醉。记录患者注射麻药前冷热诊、注射麻药后冷热诊以及治疗过程中的VAS值。中度或者重度疼痛者则使用4%阿替卡因肾上腺素注射液(必兰)补充牙周韧带麻醉(AS组与BS组)。在开髓、拔髓、根管预备过程中无痛或者轻度疼痛被视为麻醉成功。比较各组间的麻醉成功率。统计结果使用SPSS22.0软件进行fisher检验。结果补充麻醉前A组麻醉成功率:第一磨牙44.4%、第二磨牙38.9%、前磨牙45.5%;B组麻醉成功率:第一磨牙47.6%、第二磨牙39.3%、前磨牙87.5%。补充麻醉后A组麻醉成功率:第一磨牙83.3%、第二磨牙91.7%、前磨牙100%;B组麻醉成功率:第一磨牙90.5%、第二磨牙92.9%、前磨牙100%。补充麻醉前两组间麻醉成功率在磨牙无统计学差异(P0.05);但是在前磨牙麻醉成功率浸润麻醉高于阻滞麻醉,其差异有统计学意义(p0.05);A组前磨牙麻醉成功率与磨牙麻醉成功率无统计学差异,但是B组前磨牙麻醉成功率高于磨牙麻醉成功率,其差异有统计学意义(p0.05)。补充麻醉后两组间的差异在磨牙、前磨牙均无统计学意义,但是补充麻醉后第一磨牙、第二磨牙的麻醉成功率在A、B两组均高于未补充麻醉前,差异具有统计学意义(p0.05)。结论下颌磨牙不可逆性牙髓炎患者使用两种麻醉方法可以取得相似的成功率,但是下颌前磨牙患者浸润麻醉可以取得比阻滞麻醉更高的成功率。前磨牙浸润麻醉成功率高于磨牙浸润麻醉。补充牙周韧带麻醉可以提高下颌磨牙的麻醉成功率。
[Abstract]:Objective to compare block anesthesia. The anesthetic effect of invasive anesthesia and periodontal ligament replacement anesthesia in the treatment of irreversible pulpitis of mandibular posterior teeth. Materials and methods collected from February 2016 to April 2017 in the Stomatology Hospital of Shandong University. 140 patients with posterior irreversibility pulpitis. There were 130 subjects (57 males and 73 females), aged 18-65 years, with 39 first molars and 64 second molars. Twenty seven mandibular premolars were randomly divided into two groups. Group A was treated with 2% lidocaine hydrochloride injection under lower alveolar, buccal and tongue block anesthesia. Group B was treated with 4% Atevacaine epinephrine injection (Bi-lan) under buccal and lingual infiltration anesthesia. VAS value of cold and hot diagnosis and treatment after injection of anesthetic. Patients with moderate or severe pain were treated with 4% Atevacaine epinephrine injection (Beilan) to supplement periodontal ligament anesthesia group as and BS group). Open the marrow. Pulping. Painless or mild pain during root canal preparation was regarded as successful anaesthesia. The success rate of anesthesia was compared among groups. The statistical results were tested by fisher using SPSS22.0 software. Success rate of anesthesia:. First molar 44.4%. The second molar was 38.9 and the premolar was 45.5; The success rate of anesthesia in group B was 47.6 for the first molar, 39.3 for the second molar and 87.5for the premolar. After supplementary anesthesia, the success rate of anesthesia in group A was 83.3 for the first molar and 91.7% for the second molar. 100 parts of premolars; The success rate of anesthesia in group B was 90.5 for the first molar, 92.9 for the second molar and 100 for the premolar. There was no significant difference in the success rate of anesthesia between the two groups before supplementary anesthesia (P 0.05). But the success rate of invasive anesthesia in premolar was higher than that of block anesthesia, and the difference was statistically significant (P 0.05). There was no statistical difference between the success rate of premolar anesthesia and that of molar anesthesia in group A, but the success rate of premolar anesthesia in group B was higher than that of molar anesthesia. After supplementary anesthesia, the difference between the two groups was not statistically significant in molar and premolar, but the success rate of first molar and second molar after supplementary anesthesia was in A. The difference between group B and group B was statistically significant (P 0.05). Conclusion the two anesthesia methods can achieve similar success rate in patients with irreversible pulpitis of mandibular molars. The success rate of premolar infiltration anesthesia is higher than that of mandibular premolar infiltration anesthesia, and that of mandibular premolar infiltration anesthesia is higher than that of molar infiltration anesthesia, and the rate of mandibular molar anesthesia can be improved by supplementing periodontal ligament anesthesia. .
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.054

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