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題名 | A Retrospective Study of Dental Treatment under General Anesthesia of Children with or without a Chronic Illness and/or a Disability=重大傷病及/或身心障礙兒童與一般兒童在全身麻醉下進行全面性牙科治療的回溯研究 |
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作者 | 蔡佳玲; 蔡宜玲; 林瑩澤; 林雅婷; Tsai, Chia-ling; Tsai, Yi-ling; Lin, Yng-tzer; Lin, Yai-tin; |
期刊 | 長庚醫學 |
出版日期 | 20060700、20060800 |
卷期 | 29:4 民95.07-08 |
頁次 | 頁412-418 |
分類號 | 417.69 |
語文 | eng |
關鍵詞 | 全身麻醉; 全面性牙科治療; 身心障礙兒童; General anesthesia; Comprehensive dental treatment; Disability; |
中文摘要 | 背景:對於患有猛暴性齲齒又缺乏合作能力或極度害怕的兒童,或患有重大或特殊疾病及身心障礙的患者,不適合在牙科治療椅上治療者,以「全身麻醉下進行全面性牙科治療」的全口復健方式,可說是相當合適。本研究即比較在此種治療方式下的慢性疾病及/或身心障礙兒童與一般兒童之特性及治療方針上的異同。 方法:收集2002年所有在高雄長庚醫院18歲以下於全身麻醉下進行全口齲齒治療之184位兒童,患有慢性疾病及/或身心障礙的56位兒童為第一組,其他128位一般兒童為第二組。以回溯研究分析患者之性別、年齡、住院與否、齲齒數、牙科處置頂目、手術時間及ASA分級特性。 結果:兩組兒童齲齒數目月顯著差異(p=0.9228),平均15顆以上。第一組兒童平均治療時的年齡為6.25歲,較第二組兒童(平均4.09歲)大(p<0.0001);第一組兒童齒髓治療(p=0.003)及不鏽鋼牙冠(p=0.028)的數目較少;拔牙數目較多(p=0.006);但在填補數目及總治療數目沒有顯著差異(p=0.934及p=0.167)。 結論:慢性疾病及/或身心障礙的兒童的平均實施年齡一般兒童高,平均齒髓治療及不鏽鋼牙冠數目較少,平均拔牙數較多。推論患有慢性疾病及/或身心障礙兒童的牙科處置因為疾病拖延較久而較嚴重,所以拔牙顆數較多,齒髓治療較少。建議應建立早期轉介慢性病及身心障礙兒童至牙科的系統,以提早預防及治療。 |
英文摘要 | Background: The indications for dental treatment under general anesthesia have been described by various authors as extensive decay, behavioral management problems, a medically compromised patient, a handicapped patient, and a combination of these. Few studies have been undertaken to identify the range of treatment provided for chronically sick children. The aim of this study was to identify the characteristics of dental procedures performed under general anesthesia on children with a chronic illness and/or a disability, and compare these findings with other normal children. Methods: A retrospective, comparative study was designed. Children who received comprehensive dental treatment under general anesthesia at Kaohsiung Chang-Gung Memorial Hospital, Taiwan, in 2002 were enrolled in this study. Patients with a chronic illness and/or a disability were included in group I, and other relatively normal patients were placed in group II. Results: Group I children were significantly older than those of group II ( p < 0.0001). Different patterns of dental treatment were noted when the 2 groups were compared. Significantly greater numbers of stainless steel crown build-ups ( p = 0.028) and pulpal treatments ( p = 0.003) were found among group II patients. There was no significant between-group difference in restorations ( p = 0.934); however, group I had a significantly higher ( p = 0.006) number of extractions. Conclusions: By comparing the different patient groups receiving comprehensive dental treatment under general anesthesia, it was found that patients with a chronic illness and/or a disability had a significantly higher average surgical age and fewer pulpal treatments, received fewer stainless steel crowns, and underwent more extractions. Providing early treatment for children with a chronic illness and/or a disability may improve their dental health and maintain full dentition so as to reduce the number of subsequent tooth extractions. Thus, it is highly recommended to refer these children at an earlier age to a hospital where tooth restoration under general anesthesia can be performed. |
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