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转诊后等待全身麻醉下拔牙所引发的问题:对儿童的影响

Issues arising following a referral and subsequent wait for extraction under general anaesthetic: impact on children.

作者信息

Goodwin Michaela, Sanders Caroline, Davies Gill, Walsh Tanya, Pretty Iain A

机构信息

The Dental Health Unit, School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, M15 6SE Manchester, England.

出版信息

BMC Oral Health. 2015 Jan 17;15:3. doi: 10.1186/1472-6831-15-3.

Abstract

BACKGROUND

Untreated caries in young children can result in a referral for extraction in hospital under general anaesthetic (GA). This study aims to explore the impact of caries during the ensuing wait for GA on children resident in the North West of England.

METHODS

The study involved 456 respondents referred to six hospitals in the Northwest of England. Over a two-month period each of these children/ families completed a questionnaire and gave permission to access their referral and consultation notes.

RESULTS

Children (6.78 years old: 1.50 to 16.42) had on average five teeth extracted (ranging from one to a full clearance, with all teeth removed). Sixty seven per cent of parents reported their child had been in pain, 26% reported schools days being missed and 38% having sleepless nights. The average time from referral to operation was 137 days. Results indicated that children could be in discomfort during their wait, as pain was experienced, on average, 14 days before the operation. Wait time significantly predicated the number of sleepless nights b = .004, t(340) = 2.276, p = .023.

CONCLUSIONS

It is clear that pain, sleepless nights and missed school are a feature during a wait for dental GA and can be exacerbated by an extended wait. These data support the need for not only effective prevention of caries within primary care to reduce wait times and experience of GA but also effective management of pain and infection during a prolonged wait for treatment.

摘要

背景

幼儿未经治疗的龋齿可能导致在全身麻醉(GA)下被转诊至医院拔牙。本研究旨在探讨龋齿对居住在英格兰西北部儿童在等待全身麻醉期间的影响。

方法

该研究涉及456名被转诊至英格兰西北部六家医院的受访者。在两个月的时间里,这些儿童/家庭中的每一个都完成了一份问卷,并允许查阅他们的转诊和会诊记录。

结果

儿童(6.78岁:1.50至16.42岁)平均拔除了五颗牙齿(范围从一颗到全部拔除,即所有牙齿都被拔除)。67%的家长报告他们的孩子曾经历疼痛,26%报告孩子缺课,38%报告孩子有失眠情况。从转诊到手术的平均时间为137天。结果表明,儿童在等待期间可能会感到不适,因为平均在手术前14天就会经历疼痛。等待时间显著预测了失眠的天数,b = 0.004,t(340) = 2.276,p = 0.023。

结论

显然,在等待牙科全身麻醉期间,疼痛、失眠和缺课是常见情况,而延长等待时间会使这些情况加剧。这些数据支持不仅需要在初级保健中有效预防龋齿以减少等待时间和全身麻醉的经历,还需要在长时间等待治疗期间有效管理疼痛和感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1387/4324052/b1926eb36cfb/12903_2014_489_Fig1_HTML.jpg

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