音乐疗法在牙科焦虑症患者阻生智齿拔除术中的应用研究
发布时间：2018-11-25 10:16
【摘要】：[目的]通过流行病学调查,了解口腔颌面外科门诊拔牙患者牙科焦虑症的发病情况及流行程度,探讨拔牙患者发生牙科焦虑症可能相关的因素及观察音乐疗法在高度牙科焦虑症患者阻生智齿拔除术中的临床应用效果。[方法]1 采用改良 Corah's 牙科焦虑量表(Modified dental anxiety scale,MDAS)及牙科焦虑一般因素调查表,评估800名12岁以上门诊患者牙科焦虑症的发生情况及流行程度,应用单因素、多因素分析方法对调查对象的牙科焦虑症状及影响因素进行统计分析。2收集2016-2017年就诊于我科,需行双侧对称性下颌第三磨牙拔除的高度牙科焦虑症患者25例,采用自身对照分组方式,第一次拔牙或第二次拔牙随机完成音乐治疗组或对照组。实验组采用局部麻醉下给予音乐疗法辅助高速涡轮机拔除阻生智齿,对照组采用常规局部麻醉加高速涡轮机拔牙。分别记录2组患者术前30分钟、术前5分钟、麻醉注射时、拔牙开始时、拔牙时、拔牙结束时、术后30min时的血压、心率,并进行术后满意度、术前与术后改良牙科焦虑量表评分。[结果]1剔除无效问卷后,得到合格问卷768份,有效率为96.13%.患者年龄12～91 岁,平均(30.76±15.59)岁;MDAS 分值 4—20 分,平均(10.21±3.29)分,MDAS≥13分为有高度牙科焦虑症状,其发生率为21.4%。性别、年龄分组、拔牙时间、亲友陪伴、既往拔牙经历、亲友拔牙经历、疼痛耐受度、精神状态、健康状况、拔牙前心理状况、自评口腔卫生状况各组的牙科焦虑症患病率差异有统计学意义(P0.05);文化程度、拔牙类型、民族、生活经历、是否喜欢听音乐、性格、职业、是否初次拔牙差异没有统计学意义(P0.05)。Logistic回归分析显示,性别、是否有亲友陪伴、拔牙前心理状况、自评口腔卫生状态对牙科焦虑症的危险性较大。2在对照组中,经过统计分析可知,术后30分钟的收缩压与拔牙开始时、拔牙时的收缩压比较有统计学差异(P0.05);不同时间段的舒张压比较无统计学差异(P0.05);术后30分钟的心率与拔牙开始时、拔牙时的心率比较有统计学差异(P0.05);拔牙结束时的心率与拔牙开始时的心率比较有统计学差异(P0.05);拔牙开始时的心率与与术前5分钟比较有统计学差异(P0.05);术前5分钟与术前30分钟收缩压、舒张压、心率均无统计学差异(P0.05)。在实验组中,结束30分钟的收缩压与术前30分钟、麻醉注射时、拔牙开始时、拔牙时的收缩压比较有统计学差异(P0.05);术前5分钟的收缩压与术前30分钟、麻醉注射时、拔牙开始时、拔牙时、拔牙结束时的比较有统计学差异(P0.05);结束30分钟的舒张压与拔牙开始时、拔牙时的舒张压的比较有统计学差异(P0.05);拔牙开始时的舒张压与术前5分钟的比较有统计学差异(P0.05);结束30分钟的心率与术前30分钟、麻醉注射时、拔牙开始时、拔牙时的心率比较有统计学差异(P0.05);拔牙结束时的心率与麻醉注射时、拔牙开始时、拔牙时的心率比较有统计学差异(P0.05),术前5分钟的心率与术前30分钟、麻醉注射时、拔牙开始时、拔牙时的比较有统计学差异(P0.05)。实验组与对照组各个时间段的收缩压、舒张压、心率均无统计学差异(P0.05)。实验组患者就诊满意度高于对照组,差异有统计学意义(P0.05)。[结论]1口腔门诊拔牙患者牙科焦虑症发病率较高,应给予重视。性别、年龄、拔牙时间、亲友陪伴、既往拔牙经历、亲友拔牙经历、疼痛耐受度、精神状态、全身健康,、拔牙前心理状况,口腔卫生等是牙科焦虑症的易发因素。2音乐疗法在术前能减轻患者的焦虑状态,平稳患者的收缩压和心率。但在音乐疗法配合高速涡轮机辅助拔除下颌阻生智齿过程中不能够有效降低者的焦虑程度,平稳患者的血压和心率。3音乐疗法辅助高速涡轮机拔除阻生智齿能明显提高患者满意度。
[Abstract]:[Objective] To investigate the incidence and prevalence of dental anxiety in patients with tooth extraction in oral and maxillofacial surgery by means of epidemiological investigation. To study the possible factors related to the occurrence of dental anxiety in the patients with tooth extraction and to observe the clinical application of the music therapy in the patients with high degree of dental anxiety.[Methods] 1 The incidence of dental anxiety and the prevalence of dental anxiety in the outpatients over 12 years of age were assessed by using the modified Corrah's Dental Anxiety Scale (MDAS) and the general factors of dental anxiety. a multi-factor analysis method was used to make a statistical analysis of the dental anxiety symptoms and the influencing factors of the investigated subjects. The music treatment group or control group was randomly completed for the first tooth extraction or the second extraction. The experimental group was given the music therapy with local anesthesia to assist the high-speed turbine to remove the retarded wisdom tooth, and the control group was extracted by conventional local anesthesia and high-speed turbine. The blood pressure, heart rate, postoperative satisfaction, pre-operative and post-operative improvement of the dental anxiety scale were recorded for 30 minutes before the operation and 5 minutes before the operation.[Results] After elimination of the invalid questionnaire, 768 parts of the qualified questionnaire were obtained, and the effective rate was 96.13%. The age of the patients was 12-91 years, the average (30. 76-15. 59) years, the MDAS score was 4-20, the average (10.21-3.29), and the MDAS-13 was divided into highly-dental anxiety symptoms, with a rate of 21.4%. There was a significant difference in the prevalence of dental anxiety in various groups (P0.05). The degree of culture, the type of tooth extraction, the nationality, the life experience, whether to listen to music, character, occupation, whether the initial tooth extraction difference is not statistically significant (P0.05). Logistic regression analysis shows that the gender, whether or not there is a friend and a family, the psychological condition before the tooth extraction, The risk of dental anxiety was higher in the self-evaluation of oral hygiene. In the control group, the systolic pressure of 30 minutes after operation and the start of tooth extraction were statistically different (P0.05). The results showed that the heart rate at the end of the tooth extraction and the heart rate at the beginning of the tooth extraction were statistically different (P0.05). The heart rate at the beginning of the extraction was significantly different from that in the first 5 minutes (P0.05); the systolic blood pressure, diastolic blood pressure and heart rate were not statistically different between the first 5 minutes and the first 30 minutes before the operation (P0.05). In the experimental group, the systolic blood pressure at the end of 30 minutes was 30 minutes before the operation, and at the time of the anesthesia injection, the systolic blood pressure at the time of extraction was statistically different (P0.05); the systolic blood pressure in the first 5 minutes before the operation was 30 minutes before the operation, and when the extraction was started, the tooth extraction was started, There was a statistical difference between the end of the tooth extraction (P0.05); the diastolic blood pressure at the end of the tooth extraction and the start of the tooth extraction were statistically different (P0.05); the diastolic blood pressure at the beginning of the tooth extraction was statistically different from that of the first 5 minutes (P0.05); At the end of the extraction, the heart rate at the end of the tooth extraction was statistically different (P0.05). The heart rate at the end of the tooth extraction and the time of the anesthesia injection, the heart rate at the end of the tooth extraction and the heart rate at the time of extraction were statistically different (P0.05). The heart rate of the first 5 minutes before the operation was 30 minutes before the operation, and at the time of the anesthesia, there was a statistically significant difference in the tooth extraction at the beginning of the tooth extraction (P0.05). The systolic and diastolic blood pressure and heart rate of the experimental group and the control group were not statistically different (P0.05). The degree of satisfaction of the patients in the experimental group was higher than that of the control group (P0.05).[Conclusion] The incidence of dental anxiety in the patients with tooth extraction in the first oral clinic is high, and attention should be paid to it. "Sex, age, tooth extraction time, companionship with relatives and friends, past tooth extraction experience, tooth extraction experience, pain tolerance, mental state, general health, pre-extraction psychological condition, oral hygiene and so on are the factors that are easy for dental anxiety. Music therapy can reduce the anxiety state of the patient before the operation," The systolic and heart rate of a stable patient. however, it is not effective to reduce that degree of anxiety and the blood pressure and the heart rate of the patient in the course of music therapy combined with the high-speed turbine to assist in the removal of the jaw-resistant wisdom tooth. the music therapy-assisted high-speed turbine's removal of the resistance-generating wisdom tooth can improve the patient's satisfaction.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.11
[Abstract]:[Objective] To investigate the incidence and prevalence of dental anxiety in patients with tooth extraction in oral and maxillofacial surgery by means of epidemiological investigation. To study the possible factors related to the occurrence of dental anxiety in the patients with tooth extraction and to observe the clinical application of the music therapy in the patients with high degree of dental anxiety.[Methods] 1 The incidence of dental anxiety and the prevalence of dental anxiety in the outpatients over 12 years of age were assessed by using the modified Corrah's Dental Anxiety Scale (MDAS) and the general factors of dental anxiety. a multi-factor analysis method was used to make a statistical analysis of the dental anxiety symptoms and the influencing factors of the investigated subjects. The music treatment group or control group was randomly completed for the first tooth extraction or the second extraction. The experimental group was given the music therapy with local anesthesia to assist the high-speed turbine to remove the retarded wisdom tooth, and the control group was extracted by conventional local anesthesia and high-speed turbine. The blood pressure, heart rate, postoperative satisfaction, pre-operative and post-operative improvement of the dental anxiety scale were recorded for 30 minutes before the operation and 5 minutes before the operation.[Results] After elimination of the invalid questionnaire, 768 parts of the qualified questionnaire were obtained, and the effective rate was 96.13%. The age of the patients was 12-91 years, the average (30. 76-15. 59) years, the MDAS score was 4-20, the average (10.21-3.29), and the MDAS-13 was divided into highly-dental anxiety symptoms, with a rate of 21.4%. There was a significant difference in the prevalence of dental anxiety in various groups (P0.05). The degree of culture, the type of tooth extraction, the nationality, the life experience, whether to listen to music, character, occupation, whether the initial tooth extraction difference is not statistically significant (P0.05). Logistic regression analysis shows that the gender, whether or not there is a friend and a family, the psychological condition before the tooth extraction, The risk of dental anxiety was higher in the self-evaluation of oral hygiene. In the control group, the systolic pressure of 30 minutes after operation and the start of tooth extraction were statistically different (P0.05). The results showed that the heart rate at the end of the tooth extraction and the heart rate at the beginning of the tooth extraction were statistically different (P0.05). The heart rate at the beginning of the extraction was significantly different from that in the first 5 minutes (P0.05); the systolic blood pressure, diastolic blood pressure and heart rate were not statistically different between the first 5 minutes and the first 30 minutes before the operation (P0.05). In the experimental group, the systolic blood pressure at the end of 30 minutes was 30 minutes before the operation, and at the time of the anesthesia injection, the systolic blood pressure at the time of extraction was statistically different (P0.05); the systolic blood pressure in the first 5 minutes before the operation was 30 minutes before the operation, and when the extraction was started, the tooth extraction was started, There was a statistical difference between the end of the tooth extraction (P0.05); the diastolic blood pressure at the end of the tooth extraction and the start of the tooth extraction were statistically different (P0.05); the diastolic blood pressure at the beginning of the tooth extraction was statistically different from that of the first 5 minutes (P0.05); At the end of the extraction, the heart rate at the end of the tooth extraction was statistically different (P0.05). The heart rate at the end of the tooth extraction and the time of the anesthesia injection, the heart rate at the end of the tooth extraction and the heart rate at the time of extraction were statistically different (P0.05). The heart rate of the first 5 minutes before the operation was 30 minutes before the operation, and at the time of the anesthesia, there was a statistically significant difference in the tooth extraction at the beginning of the tooth extraction (P0.05). The systolic and diastolic blood pressure and heart rate of the experimental group and the control group were not statistically different (P0.05). The degree of satisfaction of the patients in the experimental group was higher than that of the control group (P0.05).[Conclusion] The incidence of dental anxiety in the patients with tooth extraction in the first oral clinic is high, and attention should be paid to it. "Sex, age, tooth extraction time, companionship with relatives and friends, past tooth extraction experience, tooth extraction experience, pain tolerance, mental state, general health, pre-extraction psychological condition, oral hygiene and so on are the factors that are easy for dental anxiety. Music therapy can reduce the anxiety state of the patient before the operation," The systolic and heart rate of a stable patient. however, it is not effective to reduce that degree of anxiety and the blood pressure and the heart rate of the patient in the course of music therapy combined with the high-speed turbine to assist in the removal of the jaw-resistant wisdom tooth. the music therapy-assisted high-speed turbine's removal of the resistance-generating wisdom tooth can improve the patient's satisfaction.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.11
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