本文選題：高血壓　切入點(diǎn)：牙髓炎　出處：《北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2016年01期

【摘要】：目的:評(píng)估不同高血壓分級(jí)患者治療急性牙髓炎過程中的生命體征變化和影響因素,以獲得風(fēng)險(xiǎn)預(yù)防措施。方法:納入2014年2月至2015年2月間就診于北京大學(xué)口腔醫(yī)院急診科的不同高血壓分級(jí)的急性牙髓炎患者90例,收集患者的全身健康狀況、口腔治療情況、生命體征的變化等信息,根據(jù)高血壓患者的心腦血管風(fēng)險(xiǎn)評(píng)估分型,把納入研究的患者分為牙髓炎治療的低危組、中危組和高危組各30例。結(jié)果:(1)與術(shù)前相比,高危組術(shù)中收縮壓升高、舒張壓升高、心率增快的比例都在80%以上(分別為90%、80%、100%),中危組和低危組各項(xiàng)指標(biāo)升高的比例明顯低于高危組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);同時(shí),高危組超過1/4(26.7%)的患者收縮壓增幅大于20 mm Hg(1 mm Hg=0.133 k Pa),2/5的患者舒張壓增幅大于10 mm Hg,與中危組和低危組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)與術(shù)前相比,高危組術(shù)中收縮壓和舒張壓變化的最大峰值均增高,收縮壓增高(18.0±1.5)mm Hg,舒張壓增高(8.0±1.7)mm Hg,心率變化均值也增加了(7.0±0.3)次/min,而低危組和中危組這兩項(xiàng)指標(biāo)均下降;高危組有6例在治療過程中出現(xiàn)心電圖改變,低危組和中危組則無明顯改變。(3)術(shù)前初評(píng)、術(shù)后終評(píng)的風(fēng)險(xiǎn)評(píng)估對(duì)比發(fā)現(xiàn),中危組患者在術(shù)后被評(píng)價(jià)為中等危險(xiǎn)的有23例,6例被評(píng)價(jià)為低等危險(xiǎn),1例為高等危險(xiǎn)(風(fēng)險(xiǎn)評(píng)級(jí)增加);高危組術(shù)后被評(píng)價(jià)為高等危險(xiǎn)的有20例,7例被評(píng)價(jià)為極高危險(xiǎn),3例為中等危險(xiǎn)(風(fēng)險(xiǎn)評(píng)級(jí)降低)。結(jié)論:口腔治療對(duì)于高血壓患者來說是非常安全的,但危險(xiǎn)因素、靶器官受損及并發(fā)癥也會(huì)增加高血壓患者在治療過程中出現(xiàn)心血管意外的風(fēng)險(xiǎn),因此應(yīng)該采取一定措施來規(guī)避風(fēng)險(xiǎn)。
[Abstract]:Objective: to evaluate the changes of vital signs and influencing factors during the treatment of acute pulpitis in patients with different grades of hypertension.Methods: from February 2014 to February 2015, 90 patients with acute pulpitis with different grades of hypertension were enrolled in the emergency department of Peking University Stomatology Hospital. The patients' general health status and oral treatment were collected.According to the cardiovascular and cerebrovascular risk assessment of hypertensive patients, the patients included in the study were divided into three groups: low risk group, middle risk group and high risk group.At the same time, the increase of systolic blood pressure in patients with high risk group was more than 20 mm Hg(1 mm Hg=0.133 k Pax 2 / 5, which was more than 10 mm Hg, which was significantly higher than that in moderate and low risk group.The peak values of systolic and diastolic blood pressure in high risk group were all increased, systolic blood pressure increased by 18.0 鹵1.5)mm Hg, diastolic blood pressure increased by 8.0 鹵1.7)mm Hg, and the mean heart rate increased by 7.0 鹵0.3 times / min, but both in low risk group and moderate risk group decreased.In high risk group, electrocardiogram changes occurred in 6 cases during treatment, but no significant change was found in low risk group and moderate risk group.Of the 23 patients in the moderate risk group who were evaluated as moderate risk after operation, 6 were evaluated as low risk and 1 as high risk (increased risk rating), while 20 patients in high risk group were evaluated as high risk after operation. 7 patients with high risk were evaluated as extremely highThere were 3 cases of moderate risk (lower risk rating).Conclusion: oral treatment is very safe for patients with hypertension, but risk factors, target organ damage and complications also increase the risk of cardiovascular accidents in patients with hypertension.Therefore, certain measures should be taken to avoid risks.
【作者單位】： 北京大學(xué)口腔醫(yī)學(xué)院·口腔醫(yī)院急診科;
【分類號(hào)】：R544.1;R781.31

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