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。对于牙科患者，认为晕厥、转圈是由于对治疗的恐惧感和焦虑、针头植入、疼痛而发生的。我们记录了患者在牙科治疗过程中的自主神经活动。方法：采用口腔外科手术治疗（拔除第三磨牙和门诊小手术）对口腔患者自主神经活动的影响进行研究。将患者分为对照组（C组）和静脉镇静组（S组）。采用无创血压测量仪测量收缩压和舒张压，心率、SpO 2（BP-88，Nippon Coline）、心率变异性（Tarawa/Win，CMS）。观察治疗前（pre）、镇静剂给药后（sed：仅S组）、 ...更多信息 局部麻醉时间（la）、局部麻醉5分钟后（post-la）、拔牙时间（ext）、治疗后时间（post）。在寻找低频成分（LF）和高频成分（HF）时，我们将LF/HF评价为交感神经活动，将HF评价为副交感神经活动。结果：C组各测量时间点血压无明显变化，S组下降。两组心率在术后均呈上升趋势。C组各测量时间点的LF/HF和HF的自主神经活动无明显变化。在S组，HF成为下降的趋势，每个测量时间后sed。讨论：它是调查的影响，第三磨牙拔除给自主神经活动的患者。关于循环变化，两组在la后心率升高被认为与局部麻醉剂的影响有关。此外，由于咪达唑仑镇静的循环抑制作用，认为静脉镇静有助于降低S组sed的血压。牙科治疗中的自主神经活动不能用这种方法捕捉，或者针刺的疼痛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在静脉穿刺时引起意识不清时，我们能够观察到低血压、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。在静脉镇静中进行静脉穿刺以缓解压力时，认为有必要多加考虑，以免引起令人不快的症状。少