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全身麻醉下有和无智力残疾患者的比较:一项回顾性研究。

Comparison of patients with and without intellectual disability under general anesthesia: A retrospective study.

作者信息

Sitilci T, Demirgan S, Akcay C, Kahraman N, Koseoglu B G, Erdem M A, Cankaya A B

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, İstanbul, Turkey.

Department of General Anesthesia, Düzce Public Hospital, Düzce, Turkey.

出版信息

Niger J Clin Pract. 2017 Apr;20(4):438-444. doi: 10.4103/1119-3077.204372.

Abstract

BACKGROUND AND PURPOSE

We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia.

MATERIALS AND METHODS

A total of 348 patients were selected from the Department of Maxillofacial Surgery and the Department of Pedodontics who underwent surgery with general anesthesia. Medical histories of all patients were taken, and their electrocardiography, chest X-rays, complete blood count, and blood clotting tests were checked during a preoperative assessment. Mallampati evaluations were also performed. Patients were grouped into ASA I, II, or III according to the ASA classification and were treated under general anesthesia.

RESULTS

There was no significant difference between normal and intellectually disabled patients in terms of gender, Mallampati scores, intubation difficulties, mean anesthetic period, time to discharge, or postoperative nausea and vomiting. Epilepsy and genetic diseases in intellectually disabled patients were significantly more common than in non-ID (NID) patients. However, the frequency of diabetes and chronic obstructive pulmonary disease in NID patients was significantly higher than in the intellectually disabled patients.

CONCLUSION

Dental treatment of intellectually disabled patients under general anesthesia can be performed just as safely as that with NID patients.

摘要

背景与目的

我们对2012年10月至2013年6月期间在伊斯坦布尔大学牙科学院全身麻醉科接受口腔手术的有智力障碍(ID)和无智力障碍的患者进行了分析和回顾性比较,涉及以下类别:人口统计学特征、美国麻醉医师协会(ASA)分级、马兰帕蒂评分、手术期间使用的麻醉药物类型、插管类型、气管插管有无困难、全身性疾病的存在情况以及全身麻醉结束后的恢复时间。

材料与方法

从颌面外科和儿童牙科选择了348例接受全身麻醉手术的患者。记录所有患者的病史,并在术前评估期间检查他们的心电图、胸部X光、全血细胞计数和凝血试验。还进行了马兰帕蒂评估。根据ASA分级将患者分为ASA I、II或III级,并在全身麻醉下进行治疗。

结果

在性别、马兰帕蒂评分、插管困难、平均麻醉时间、出院时间或术后恶心呕吐方面,正常患者和智力障碍患者之间没有显著差异。智力障碍患者中的癫痫和遗传疾病比非智力障碍(NID)患者明显更常见。然而,NID患者中糖尿病和慢性阻塞性肺疾病的发生率明显高于智力障碍患者。

结论

在全身麻醉下对智力障碍患者进行牙科治疗与对NID患者进行治疗一样安全。

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