快適な歯科治療を目指して―自律神経解析からみた歯科治療が患者におよぼす影響―

追求舒适的牙科治疗 - 从植物神经分析看牙科治疗对患者的影响 -

• 批准号: 13672121
• 负责人: ABE Koichiro
• 金额: $ 1.92万
• 依托单位: TOKYO DENTAL COLLEGE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13672121/
• 关键词: HEART RATE VARIABILITY; AUTONOMIC NERVE ANALYSIS; DENTAL TREATMENT

Purpose: The dentists experience that the patient during dental treatment becomes unpleasant. For the dental patient It is thought that syncope, circle drifting occur by fear feeling for treatment and anxiety, needle implant, pain. We recorded autonomic nerve activity during dental treatment of the patient. We were aimed at reviewing whether autonomic nerve activity of the dentist patients took any kind of influence by the treatment.Methods: We investigated the influence that oral surgery treatment (extraction ofthird molar and minor surgery for the outpatients)gives autonomic nerve activity. We divided the patient into control group (only monitoring, groupC) and intravenous sedation group(by Midazoiam, group S). We observed systolic blood pressure and diastolic blood pressure by noninvasive measurement, heart rate, SpO2 (BP-88, Nippon Coline), heart rate variability (Tarawa/Win, CMS). We observed it pre-treatment (pre), after administration of sedative agent (sed: only S group), at th … More e time of a local anesthesia (la), local anesthesia five minutes later (post-la), extraction (ext), post-treatment (post). In search of a low frequency ingredient (LF) and a high frequency ingredient (HF),we evaluated LF/HF as sympathetic nervous activity, HF as parasympathetic nerve activity. We compared group S with group C.Results: The blood pressure did not have a change in group C by each measurement time, decreased sed in group S. The heart rate showed a rise tendency in post-la in both groups. The autonomic nerve activity did not accept a change in LF/HF and HF of each measurement time in group C. In group S, HF became a fall tendency by each measurement time after sed.Discussion: It was investigated the influence that the third molar extraction gave autonomous nerve activity of the patient. About a circulation change, the heart rate rise in post-la by both groups was thought about with influence of local anesthetibs. In addition, as a circulation inhibition effect by midazolam sedation, it was thought that the intravenous sedation was useful for decrease of blood pressure in sed in group S. The autonomous nerve activity that dentistry was under treatment was not able to be caught in this methods or a pain of a needte and a pain of treatment moved a body, and a record of autonomous nerve activity may have beenbninfluenced. However, when unconsciousness was caused at vein puncture with the dentistry treatment phobia patient, we were able to observe hypotension, bradycardrc circulation inhibition, and a slight LF/HF fall and a slight HF rise as autonomous nerve activity. To need vein puncture in intravenous sedation for stress relaxation, it was thought that consideration more was necessary so that an unpleasant symptom was not caused. Less

目的：牙医的经验，病人在牙科治疗变得不愉快。对于牙科病人来说，晕厥、圆漂移被认为是由于对治疗的恐惧感和焦虑、针植入、疼痛而发生的。我们记录了患者在牙科治疗期间的自主神经活动。我们的目的是审查是否自主神经活动的牙医患者采取任何形式的影响治疗。方法：探讨口腔手术治疗（拔第三磨牙和门诊小手术）对自主神经活动的影响。我们将患者分为对照组（仅监测，pc组）和静脉镇静组（咪达唑安定，S组）。我们通过无创测量来观察收缩压和舒张压、心率、SpO2 （BP-88, Nippon Coline）、心率变异性（Tarawa/Win， CMS）。观察治疗前（pre）、给药后（仅S组）、局部麻醉时间（la）、局部麻醉5分钟后（la后）、拔牙（ext）、治疗后（post）。为了寻找低频成分（LF）和高频成分（HF），我们将LF/HF评估为交感神经活动，HF评估为副交感神经活动。将S组与C组进行比较。结果：C组各测量时间血压无变化，S组血压下降，两组术后心率均有升高趋势。c组自主神经活动不接受每次测量时间的LF/HF和HF的变化。S组sed后每次测量时间HF均呈下降趋势。讨论：探讨第三磨牙拔除对患者自主神经活动的影响。在循环变化方面，两组患者术后心率升高与局部麻醉的影响有关。此外，由于咪达唑仑镇静的循环抑制作用，认为静脉镇静对s组患者血压的降低有帮助。牙科正在治疗的自主神经活动在这种方法中无法捕捉到，或者针刺和治疗的疼痛移动了身体，自主神经活动的记录可能受到影响。然而，当牙科治疗恐惧症患者静脉穿刺引起意识不清时，我们可以观察到低血压，心动过缓循环抑制，LF/HF轻微下降和HF轻微上升作为自主神经活动。静脉镇静减压需静脉穿刺，认为需多加考虑，以免引起不良症状。少