下颌阻生智齿拔除术后辅助药物应用的疗效观察

中国口腔医学继续教育杂志 ›› 2021, Vol. 24 ›› Issue (6): 350-354.

下颌阻生智齿拔除术后辅助药物应用的疗效观察

胡丽茹, 代子佳, 曹志炜, 张坤, 叶立, 潘剑

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院口腔颌面外科,四川成都（610041)

出版日期:2021-11-30 发布日期:2022-03-01
通讯作者: 潘剑,联系方式 028-85501440,电子邮箱 jianpancn@163.com

Online:2021-11-30 Published:2022-03-01

摘要/Abstract

摘要： 目的研究下颌阻生智齿拔除后应用辅助药物对减轻术后并发症的临床效果。方法选取2015年3月到2015年7月在四川大学华西口腔医院口腔颌面外科门诊行下颌第三磨牙拔除术1455例患牙。本文为队列研究,术后第7天对患者进行随访。记录入组患者的疼痛、肿胀、感染等术后并发症以及术后辅助药物应用情况,进行单变量Logistic 回归分析。结果术后使用激素类药物的患者术后疼痛的概率是未使用激素类的0.73倍（P=0.038）,术后口服非甾体抗炎药的患者发生肿胀的概率是未口服非甾体抗炎药的0.63倍（P<0.001）,结果有统计学意义。结论下颌阻生智齿拔除后使用激素类药物与非甾体抗炎药,可有效缓解术后疼痛、肿胀。

关键词: 下颌阻生第三磨牙, 牙拔除术, 并发症, 地塞米松, 非甾体类抗炎药

胡丽茹, 代子佳, 曹志炜, 张坤, 叶立, 潘剑. 下颌阻生智齿拔除术后辅助药物应用的疗效观察[J]. 中国口腔医学继续教育杂志, 2021, 24(6): 350-354.

参考文献

[1] Bouloux GF, Steed MB, Perciaccante VJ.Complications of third molar surgery.[J] Oral Maxillofac Surg Clin North Am, 2007,19(1):117-28. DOI: 10.1016/j.coms.2006.11.013.
[2] Isola G, Matarese M, Ramaglia L, et al.Evaluation of the efficacy of celecoxib and ibuprofen on postoperative pain, swelling, and mouth opening after surgical removal of impacted third molars: a randomized, controlled clinical trial.[J] Int J Oral Maxillofac Surg, 2019, 48(10):1348-1354. DOI: 10.1016/j.ijom.2019.02.006.
[3] Chugh A, Patnana AK, Kumar P, et al.Critical analysis of methodological quality of systematic reviews and meta-analysis of antibiotics in third molar surgeries using AMSTAR 2.[J] J Oral Biol Craniofac Res, 2020, 10(4):441-449. DOI: 10.1016/j.jobcr.2020.07.011.
[4] 张志愿. 口腔颌面外科学[M].人民卫生出版社.. 2012: 112-137.
[5] Sayed N, Bakathir A, Pasha M, et al.Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman.[J] Sultan Qaboos Univ Med J, 2019, 19(3):e230-e235. DOI: 10.18295/squmj.2019.19.03.009.
[6] 陈佳锐, 陈邦俊, 郑相淮. 地塞米松不同给药途径对下颌阻生第三磨牙拔除术后的疗效观察[J]. 中国美容医学, 2020, 029(005):140-143.
[7] Almeida RAC, Lemos CAA, de Moraes SLD, et al. Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials.[J] Int J Oral Maxillofac Surg, 2019, 48(1):118-131. DOI: 10.1016/j.ijom.2018.05.023.
[8] Falci SGM, Lima TC, Martins CC, et al.Preemptive Effect of Dexamethasone in Third-Molar Surgery: A Meta-Analysis.[J] Anesth Prog, 2017, 64(3):136-143. DOI: 10.2344/anpr-64-05-08.
[9] Perrone MG, Scilimati A, Simone L, et al.Selective COX-1 inhibition: A therapeutic target to be reconsidered.[J] Curr Med Chem, 2010, 17(32):3769-805. DOI: 10.2174/092986710793205408.
[10] Choi SH, Aid S, Caracciolo L, et al.Cyclooxygenase-1 inhibition reduces amyloid pathology and improves memory deficits in a mouse model of Alzheimer’s disease.[J] J Neurochem, 2013, 124(1):59-68. DOI: 10.1111/jnc.12059.
[11] Nissen SE, Yeomans ND, Solomon DH, et al.Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis.[J] N Engl J Med, 2016, 375(26):2519-29. DOI: 10.1056/NEJMoa1611593.
[12] Siddiqi A, Morkel JA, Zafar S.Antibiotic prophylaxis in third molar surgery: A randomized double-blind placebo-controlled clinical trial using split-mouth technique.[J] Int J Oral Maxillofac Surg, 2010, 39(2):107-14. DOI: 10.1016/j.ijom.2009.12.014.
[13] Adde CA, Soares MS, Romano MM, et al.Clinical and surgical evaluation of the indication of postoperative antibiotic prescription in third molar surgery.[J] Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(5 Suppl):S26-31. DOI: 10.1016/j.tripleo.2011.08.018.
[14] 薛芃, 侯锐, 尚磊,等. 抗菌药物对下颌阻生第三磨牙拔除后炎性并发症影响的临床观察[J]. 中华口腔医学杂志, 2014, 49(010):603-606.