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特殊需求患者與一般孩童在全身麻醉下進行全面性牙科治療的比較

Comparative Study of Oral Health Status in Dental Treatment Under General Anesthesia in Pediatric Patients with and Without Special Health Care Needs

摘要


目的:比較特殊需求患者(patients with special health care needs; SHCN)和一般孩童(normal patients)在全身麻醉下進行全口重建,分析患者的特性以及治療上的差異。方法: 本篇為回溯性研究,紀錄2014年10月到2017年11月期間,在台北馬偕醫院兒童牙科於全身麻醉下進行全口牙科治療的孩童。分析患者的性別、年齡、齲齒數、牙科治療項目及手術時間。結果:共有81位孩童納入研究中,平均年齡為4.6歲。特殊需求患者平均年齡為5.7歲,較一般孩童(3.8歲)大(p<0.01),其中又以腦性麻痺(cerebral palsy)患者平均年齡最大(7.9歲)(p<0.001)。平均蛀牙顆數為13.6顆,各組間沒有顯著差異。而拔牙顆數在特殊需求患者較多(p<0.05),兩組在窩溝封填、樹脂填補、不銹鋼牙套以及治療時間沒有顯著差異。然而腦性麻痺患者牙髓治療比其他特殊需求患者與一般孩童來得少(p<0.05)。若以年齡做分類(小於3歲、3到6歲、大於6歲),大於6歲的孩童其不鏽鋼牙套較少(p<0.001)、前牙樹脂牙套較少(p<0.01),拔牙較多(p<0.05)。結論:在全身麻醉下進行牙科治療的特殊需求患者與一般孩童的蛀牙顆數沒有差異,但拔牙的顆數以特殊需求患者與大於6歲以上的孩童較多。

並列摘要


Purpose: To identify the oral health status and characteristics of dental treatment under general anesthesia (GA) in pediatric patients with and without special health care needs (SHCN). Methods: A retrospective and comparative study was conducted of SHCN (n=37) and normal (n=44) pediatric patients treated under GA at Mackay Memorial Hospital from October 2014 to November 2017. The gender, age, type of SHCN, type of treatment, duration of treatment were gathered. Results: Our study included 81 children, ranging in ages of 2.0 to 15.11 years (4.6±2.5 years). The average age of SHCN patients (5.7±2.10 years) was older than that of normal patients (3.8±1.5 years) (p<0.01), and the physical impairment patients (7.9±4 years) were significantly older than others (p<0.001). The mean number of decay teeth was 13.6±4.0, and no significant difference between all groups. The average extracted teeth was higher in SHCN patients (1.76±2.3) than normal patients (0.48±1.15) (p<0.05). No significant difference in sealant, composite resin filling, stainless-steel crown, and duration of treatment. However, the physical impairment patients had less pulp therapy compare to intellectual impairment patients (p<0.05) and the normal patients (p<0.05). Among age groups (2-3 years, 3-6 years, >6 years), the > 6-years-old group had the lowest mean number of treated teeth by less stainless-steel crowns (p<0.001) and less strip crowns (p<0.01), but more extractions (p<0.05). Conclusions: No difference in the number of the decay teeth between SHCN patients and normal patients who received dental treatment under GA, but the number of extractions was higher in the SHCN patients and the > 6-years-old group.

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