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中国儿童牙科全身麻醉术后并发症:一项横断面研究。

Postoperative complications in Chinese children following dental general anesthesia: A cross-sectional study.

作者信息

Zhang Qiong, Deng Xiaoyu, Wang Yan, Huang Ruijie, Yang Ran, Zou Jing

机构信息

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

出版信息

Medicine (Baltimore). 2020 Nov 6;99(45):e23065. doi: 10.1097/MD.0000000000023065.

Abstract

Dental general anesthesia (DGA) is a safe and high-quality restorative and preventive treatment option for children with severe early childhood caries (S-ECC), who require extensive dental treatment and exhibit anxiety and emotional or cognitive immaturity or are medically compromised. However, several postoperative complications have been reported in children under DGA. This study aimed to evaluate and analyze the prevalence of the relevant factors of postoperative complications in healthy Chinese children following DGA to provide a foundation for pre-, intra-, and postoperative overall health management for healthy and disabled children after DGA.A total of 369 systematically healthy Chinese children (36-71 months old) undergoing a DGA were studied. Data were collected on patients' histories, characteristics, anesthesia, and dental procedures. Parents or caregivers were interviewed before and 72 hours after the procedure. Data were analyzed using logistic regression.Approximately 94.86% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain (62.70%), followed by weariness, agitation, masticatory problems, drowsiness, oral bleeding, coughing, fever, sore throat, nausea, constipation, epistaxis, vomiting, excitement, and diarrhea. The long duration of the operation was a risk factor for postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever.Prolonged operation means complex treatment, such as pulp therapy or extraction. We speculate that the longer the duration is, the more difficult the dental procedures are. The accumulation of discomfort leads to pain. We suspect that children in lower nutritional levels are more likely to suffer from bacteremia or dehydration, resulting in fever.Postoperative pain was the most prevalent complication after the DGA. A decrease in dental procedure duration might reduce the odds of postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever. Children with low nutritional status could be more susceptible to postoperative fever.

摘要

牙科全身麻醉(DGA)是患有重度幼儿龋齿(S-ECC)儿童的一种安全且高质量的修复和预防性治疗选择,这些儿童需要进行广泛的牙科治疗,表现出焦虑以及情绪或认知不成熟,或者存在医学上的问题。然而,已有报道称接受DGA的儿童会出现一些术后并发症。本研究旨在评估和分析健康中国儿童在接受DGA后术后并发症相关因素的发生率,为DGA后健康和残疾儿童的术前、术中和术后整体健康管理提供依据。

共有369名系统健康的中国儿童(36至71个月大)接受了DGA并参与研究。收集了患者病史、特征、麻醉和牙科手术的数据。在手术前和手术后72小时对家长或护理人员进行了访谈。使用逻辑回归分析数据。

约94.86%的入选儿童报告了一种或多种并发症。最常见的并发症是术后疼痛(62.70%),其次是疲倦、烦躁、咀嚼问题、嗜睡、口腔出血、咳嗽、发热、喉咙痛、恶心、便秘、鼻出血、呕吐、兴奋和腹泻。手术时间长是术后疼痛和疲倦的危险因素。高营养状况可能是术后发热的保护因素。

手术时间延长意味着治疗复杂,如牙髓治疗或拔牙。我们推测手术时间越长,牙科手术难度越大。不适的积累导致疼痛。我们怀疑营养水平较低的儿童更容易发生菌血症或脱水,从而导致发热。

术后疼痛是DGA后最常见的并发症。缩短牙科手术时间可能会降低术后疼痛和疲倦的几率。高营养状况可能是术后发热的保护因素。营养状况低的儿童可能更容易出现术后发热。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84b/7647524/eaadd0423d3d/medi-99-e23065-g001.jpg

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