- 期刊
高血壓病人之牙科處置
The Dental Treatment in Patients with Hypertension
摘要
高血壓是成年人最常見的慢性疾病，而且它的發生率會隨著年齡的增加而提高。在台灣，高血壓是非常重要而普遍的問題，其死亡率一直高居國內十大死因之內，而且研究顯示，多數高血壓患者並不知道其本身有高血壓。根據統計，牙科門診病人平均約有１０％有高血壓，其中可能只有半數知道自己有高血壓；而一般相信，一般人看牙科醫師比看內科醫師頻率更高，這更加強了牙科門診病人在受牙科醫療前接受血壓測量的重要性，如此可以偵測出尚未診斷出高血壓的病人，經由轉診而得到適當的醫療。牙醫師應該瞭解高血壓對健康的影響而調整病患的牙科醫療。一個血壓控制良好的病患其牙科醫療與一般人並沒有太大的不同；而對於已知患有高血壓的病患在進行牙科醫療前應作好血壓的測量，並詢問病人有無遵照醫囑按時服藥，若有異常應告知病人並與他的內科醫師聯繫。本文亦針對臨床上較常見的幾個問題如高血壓藥物的口腔併發病、牙科局部麻醉藥在高血壓患者的使用、站立性低血壓問題和高血壓患者在接受牙科醫療時之心理焦慮處理提出討論及建議。
並列摘要
Hypertension is one of the most common chronic diseases in adult and its incidence is increasing by age. It is a very important and popular problem and is usually within the top ten leading cause of death in Taiwan. Many patients didn’t aware that they have hypertension until they visited the physicians. According to the previous study, about 10% of the patients who visited dental department got hypertension and probably only half of them noticed that. In general speaking, people got more frequent of visiting dental department than internal medicine and we should emphasize that patients should have blood pressure measured before any dental treatment so that we can detect undiagnosed hypertensive patients and refer to the internists for better treatment. Dentist should understand the influence of hypertension on human health and adjust the dental treatment of hypertensive patients. The dental treatment for the patients with good blood pressure control is quite the same as normal patients. We should measure blood pressure before any dental treatment for the patients who have hypertension and asked them if they got medication regularly. If there is any problem, we should tell the patient and contact with his internal physician. In our article, wealso focused on some topics such as the oral complications of anti-hypertensive drugs, local anesthesia in hypertensive patients, orthostatic hypotension and psychologic anxiety of hypertensive patients while dental visiting.