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术前使用0.2%氯己定漱口水可降低与牙槽内拔牙相关的菌血症风险。

Preoperative administration of 0.2% chlorhexidine mouthrinse reduces the risk of bacteraemia associated with intra-alveolar tooth extraction.

作者信息

Ugwumba Chinedu U, Adeyemo Wasiu L, Odeniyi Olalekan M, Arotiba Godwin T, Ogunsola Folasade T

机构信息

Department of Oral and Maxillofacial Surgery (Head: Prof. A. L. Ladeinde), Lagos University Teaching Hospital, Nigeria.

Department of Oral and Maxillofacial Surgery (Head: Prof. A. L. Ladeinde), Faculty of Dental Sciences, College of Medicine, University of Lagos, P.M.B. 12003, Lagos, Nigeria.

出版信息

J Craniomaxillofac Surg. 2014 Dec;42(8):1783-8. doi: 10.1016/j.jcms.2014.06.015. Epub 2014 Jun 14.

Abstract

The aim of the study was to investigate the effect of preoperative 0.2% chlorhexidine mouthwash on the risk of bacteraemia following routine intra-alveolar tooth extraction. The study was a randomized controlled clinical study of 101 subjects who underwent intra-alveolar dental extractions under local anaesthesia. Subjects were randomly assigned to either chlorhexidine or a control group. The chlorhexidine group had 0.2% chlorhexidine mouthwash administered for 1 min before any dental manipulation, and the control group had a mouthrinse of sterile water. Blood samples were collected at baseline, 1 min and 15 min after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques. There was a statistically significant difference in the incidence of bacteraemia between the control group (52.4%) and chlorhexidine group (27.1%) (P = 0.012). Bacteraemia was most frequently detected at 1 min after extraction (33.3%). Of the 30 subjects who had positive blood culture at 1 min, bacteraemia persisted in 8 (26.7%) of the subjects after 15 min. Bacteria isolated included Staphylococcus aureus, Actinomycetes naesulendi, Prevotella species, Streptococcus spp., and Acinetobacter iwoffii. Routine use of 0.20% chlorhexidine mouthwash before dental extraction is recommended to reduce the risk of bacteraemia following tooth extraction.

摘要

本研究的目的是调查术前使用0.2%氯己定漱口水对常规牙槽内拔牙后菌血症风险的影响。该研究是一项随机对照临床研究,纳入了101名在局部麻醉下接受牙槽内拔牙的受试者。受试者被随机分为氯己定组或对照组。氯己定组在进行任何牙科操作前使用0.2%氯己定漱口水1分钟,对照组使用无菌水漱口。在拔牙前基线、拔牙后1分钟和15分钟采集血样。通过传统微生物技术对分离出的细菌进行亚培养和进一步鉴定。对照组(52.4%)和氯己定组(27.1%)的菌血症发生率存在统计学显著差异(P = 0.012)。菌血症最常在拔牙后1分钟检测到(33.3%)。在1分钟时血培养呈阳性的30名受试者中,15分钟后仍有8名受试者(26.7%)存在菌血症。分离出的细菌包括金黄色葡萄球菌、内氏放线菌、普雷沃菌属、链球菌属和沃氏不动杆菌。建议在拔牙前常规使用0.20%氯己定漱口水,以降低拔牙后菌血症的风险。

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