Liu X Q, Yang Y, Zhou J F, Liu J Z, Tan J G
Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Dec 30;53(2):390-395. doi: 10.19723/j.issn.1671-167X.2021.02.026.
To investigate the blood pressure and heart rate changes and influencing factors during single dental implant surgery.
A retrospective cohort study was conducted. Six hundred and forty cases underwent single dental implant placement in Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2016 to December 2016 were recruited in this study according to the inclusion and exclusion criteria. They were divided into different groups according to the exposure factors which were patient characteristics (gender, age) and surgical procedures (immediate placement, flap elevation, bone grafting). The correlation between blood pressure and heart rate variability during single dental implant surgery and the patient characteristics and surgical procedures were analyzed.
The average systolic blood pressure variability was 9.47%±6.45% (maximum 46.04%), the average diastolic blood pressure variability was 12.18%±9.39% (maximum 88.00%), and the average heart rate variability was 10.59%±7.68% (maximum 49.12%). The effects of age and bone grafting on blood pressure variability, and of gender and immediate placement on heart rate variability, were statistically significant ( < 0.05), respectively. The incidence of abnormal intraoperative blood pressure rise was 4.69%, of which there were 4 cases (0.63%) of systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. The incidence of abnormal intraoperative heart rate rise was 6.72%. Hierarchical analysis showed a higher risk of abnormal intraoperative blood pressure rise in the elderly (≥60 years) male patients [ < 0.05, =3.409 (95%: 1.155-10.062) ] and flap elevation with bone grafting cases [ < 0.05, =2.382 (95%: 1.126-5.040)], respectively. There was no statistically significant association between abnormal heart rate rise and patient characteristics or surgical procedures (>0.05).
There was a certain risk of blood pressure and heart rate variability during dental implant surgery. Elderly male patients and flap elevation with bone grafting were risk factors of abnormal intraoperative blood pressure rise.
探讨单颗牙种植手术过程中的血压和心率变化及其影响因素。
进行一项回顾性队列研究。根据纳入和排除标准，选取2016年1月至2016年12月在北京大学口腔医学院口腔修复科接受单颗牙种植的640例患者。根据暴露因素（患者特征，即性别、年龄；手术操作，即即刻种植、翻瓣、植骨）将患者分为不同组。分析单颗牙种植手术过程中血压和心率变异性与患者特征及手术操作之间的相关性。
平均收缩压变异性为9.47%±6.45%（最大值46.04%），平均舒张压变异性为12.18%±9.39%（最大值88.00%），平均心率变异性为10.59%±7.68%（最大值49.12%）。年龄和植骨对血压变异性的影响，以及性别和即刻种植对心率变异性的影响，分别具有统计学意义（P<0.05）。术中血压异常升高的发生率为4.69%，其中收缩压≥180 mmHg和/或舒张压≥110 mmHg的有4例（0.63%）。术中心率异常升高的发生率为6.72%。分层分析显示，老年（≥60岁）男性患者术中血压异常升高的风险较高[P<0.05，OR = 3.409（95%CI：1.155 - 10.062）]，翻瓣并植骨的病例术中血压异常升高的风险较高[P<0.05，OR = 2.382（95%CI：1.126 - 5.040）]。心率异常升高与患者特征或手术操作之间无统计学显著关联（P>0.05）。
牙种植手术过程中存在一定的血压和心率变异性风险。老年男性患者和翻瓣并植骨是术中血压异常升高的危险因素。
