嘔吐反射的原因及處理－病例報告

Etiology and Management of Gag Reflex - A Case Report

林軒竹(Hsuan-Chu Lin) ； 蘇若梅(Jo-Mei Su)

《臺灣兒童牙醫學雜誌》 19卷1期 (2019/03) Pp. 9-14

https://doi.org/10.6319/TJPD.201903_19(1).0002

摘要

嘔吐反射為正常生理的保護機制，但過度敏感的嘔吐反射患者，對於牙醫師在治療上會造成很多困擾，也會影響治療的品質與成效。影響嘔吐反射的原因有兩種，一種為體因性，直接接觸到觸發區引起；另一種為心因性，因味道、視覺或焦慮等心理因素誘發。處理方式有很多種，例如口腔訓練、轉移注意等行為處理、藥物介入、針灸等輔助療法以及治療上牙醫師可使用的小技巧等。臨床上先瞭解患者嘔吐反射的原因，再以適合的幾種處理方式應對，來降低過度嘔吐反射的狀況，使牙科治療能順利進行。本篇為一名3歲7個月男孩有過度嘔吐反射情形，於行為處理、並搭配治療上的小技巧後，漸漸能配合治療的案例。

關鍵字

嘔吐反射 ； 行為處理

並列摘要

Gag reflex is considered a normal, protective, physiological mechanism. But a patient with active gag reflex is a nightmare for the dentist, and may also be a barrier to optimal patient care. The cause of gag reflex has been categorized as either somatic (initiated by direct contact of trigger zone) or psychogenic (modulated by higher centres in the brain, and may be induced by smell, sight or anxiety). There are many management techniques, such as behavior modification technique, pharmacological methods, complimentary therapies and miscellaneous techniques. Dentist should assess the cause of gagging, and recognize whether, single or multiple factors are causing the problem. Then use some techniques to prevent and control the gagging problem. The case is reported as a 3-year-7-month-old boy with gag reflex. The patient turned to cooperate with dental treatment after behavior modification and miscellaneous techniques.

並列關鍵字

Gag reflex ； Behavior management