颞下颌关节紊乱病不同症状患者心理因素调查

目的研究颞下颌关节紊乱病（TMD）不同症状患者心理社会因素,尤其是焦虑的差别,为心理治疗对策提供试验依据。 方法206例就诊于天津医科大学口腔医院的TMD患者和201名无症状志愿者,填写症状自评量表（SCL-90）和状态-特质焦虑问卷（STAI）,根据患者主诉分组。采用SPSS 17.0统计软件,采用独立样本t检验和单因素方差分析对所有数据进行统计学分析。 结果（1）TMD患者SCL-90量表中的躯体化、抑郁、焦虑、敌对、精神病性因子得分及总分高于无症状志愿者,差异有统计学意义（t_躯体化 = 3.79,P_躯体化 = 0.000;t_抑郁 = 2.14,P_抑郁 = 0.033;t_焦虑 = 2.91,P_焦虑 = 0.004;t_敌对 = 3.93,P_敌对 = 0.000;t_精神病性 = 2.48,P_精神病性 = 0.013;t_总分 = 2.80,P_总分 = 0.005）;女性TMD患者的状态焦虑及特质焦虑得分均高于女性无症状志愿者（t_状态焦虑 = 3.52,P_状态焦虑 = 0.001;t_特质焦虑 = 4.26,P_特质焦虑 = 0.000）,两组男性之间差异无统计学意义（t_状态焦虑 = 0.36,P_状态焦虑 = 0.718;t_特质焦虑 = 0.76,P_特质焦虑 = 0.453）;（2）不同症状TMD患者在躯体化和状态焦虑方面差异有统计学意义（F_躯体化 = 2.714,P_躯体化 = 0.046;F_特质焦虑 = 3.007,P_特质焦虑 = 0.031）,具有单纯疼痛症状者躯体化得分高于单纯弹响患者（P = 0.005）,单纯弹响及疼痛伴弹响患者的特质焦虑得分高于疼痛伴开口受限者（P = 0.016）。 结论TMD患者心理健康水平比无症状人群低,主要表现在躯体化、抑郁、焦虑、敌对和精神病性方面。女性TMD患者有明显焦虑特征。单纯疼痛TMD患者躯体化比单纯弹响者更为明显。     

颌面恶性肿瘤患者术后抑郁焦虑状态干预策略的探讨

目的:了解颌面部肿瘤患者术后抑郁焦虑状态,并探讨相关的心理干预策略.方法:口腔颌面恶性肿瘤患者37例.术前利用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)测评其抑郁和焦虑状态,术后7 d再次进行的抑郁焦虑调查和相应心理干预.干预6周后再次进行抑郁和焦虑状态的评定,分析前后数据.结果:37例颌面肿瘤患者术后3 d的抑郁和焦虑状态比较严重,干预6周后,HAMD、和HAMA评分均明显减低.差异有显著性(P＜0.05).结论:颌面部肿瘤患者在手术后存在明显抑郁焦虑的状态,在关注患者身体状态恢复的同时也要关注他们的情绪状态.     

口腔颌面部血管瘤患儿家长的心理状况分析

选用<生活事件量表>和<焦虑自评量表>对口腔颌面部血管瘤患儿家长进行心理状况调查,发现口腔颌面部血管瘤患儿家长普遍处于一种负性精神状态,但这种状态却不一定表现出躯体症状.在出现的躯体症状中,以消化不良、睡眠障碍和噩梦较重.     

上前牙全瓷冠贴面修复前后患者心理状况变化的研究

目的评价上前牙美容修复治疗后患者的心理状况变化。方法选择来我院以美容为主诉要求的适合并接受瓷贴面和全瓷冠治疗的患者78例(男29例、女49例),治疗后对患者进行满意度调查。采用SCL-90问卷对患者初诊时及修复治疗3个月后的心理状况进行研究分析,Spss 13.0软件对所获资料进行均数比较、配对t检验和两独立样本t检验。结果患者对瓷贴面和全瓷冠修复效果的主观满意度分别为97.8%和100.0%。上前牙美容修复患者治疗前SCL-90躯体化、强迫症状、人际关系敏感、抑郁、焦虑、偏执和精神症状均数均高于正常。美容修复3个月后,患者心理状况得到了有效改善,躯体化、强迫症状、人际关系敏感、抑郁、焦虑和偏执改善具有显著性(P<0.05);其中人际关系敏感、抑郁和焦虑改善效果女性好于男性(P<0.05)。结论瓷贴面和全瓷冠修复具有良好的主观疗效,患者的心理状况较正常人心理状况差,治疗后心理状况得到明显改善。     

口腔颌面部创伤患者创伤后积极心理反应及相关影响因素分析

目的:了解口腔颌面部创伤患者创伤后积极心理反应及相关影响因素.方法:使用自行设计的一般资料问卷、创伤后成长评定量表和自我形象问卷对105例口腔颌面部创伤住院患者进行调查,采用SPSS 18.0软件包对所得数据进行统计学分析.结果:患者创伤后积极心理得分为56.01±17.322,自我形象平均分为51.33±7.306;男性患者创伤后在新的可能性、个人力量、自我转变、人生感悟方面得分较高,与女性相比差异显著(P＜0.05);不同年龄段创伤后积极心理反应差异均无显著性;随着文化程度的提高,患者创伤后个人力量(P=0.031)和自我转变(P=0.01)表现越积极;患者创伤后积极心理得分与自我形象得分呈负相关(r=-0.318,P＜0.001).结论:创伤后男性患者较女性有更加积极的心态.随着文化程度的提高,患者在个人力量和自我转变方面有更加积极的心理反应,而在与他人关系、新的可能性和人生感悟方面无显著变化;患者对自我形象越好,心理越积极.     

颌面部软组织创伤不同缝合法患者的心理比较

目的 探讨颌面部软组织创伤后进行皮内缝合与普通对位缝合对患者心理的影响.方法 选择颌面部软组织创伤患者200例,按随机表分成A、B两组,分别进行皮内缝合与普通对位缝合,于术前、术后1周、术后1个月、术后3个月用医院焦虑-抑郁情绪测定表（HAD）测定患者的心理,评估两种治疗方法对患者心理的影响.结果 术后1周及1个月内,采用皮内缝合治疗组,有抑郁-焦虑情绪的患者数较普通对位缝合治疗组少,两者差异有统计学意义（P＜0.05）,而术前及术后3个月,两者差异均无统计学意义.结论 皮内缝合法对颌面部软组织创伤患者的心理影响较小,是较为理想的缝合方法.     

初戴固定矫治器时青少年患者的心理变化分析

目的探讨初戴固定矫治器是否会对青少年错畸形患者产生一定的心理负面影响。方法选取150例青少年错畸形患者,分别在就诊当日（T1期）与固定矫治器戴入1周后（T2期）填写心理调查问卷,该问卷包含焦虑自评量表和抑郁自评量表,调查患者的焦虑和抑郁情绪。根据T1与T2期2个量表的评分,比较固定矫治器戴入前后患者的心理变化。结果129例患者完成了调查。女性患者T2期的焦虑与抑郁评分均较T1期有明显升高;非自愿就诊和拔牙矫治患者在T2期焦虑与抑郁评分升高,与T1期相比差异有统计学意义（P<0.05）。结论初戴固定矫治器所引起的不适与不便可使青少年女性患者、非自愿就诊和拔牙矫治患者产生一定的焦虑与抑郁情绪。     

口腔颌面创伤后的早期心理测评及心理干预

目的：探讨性格因素对口腔颌面创伤患者心理干预临床效果的影响。方法：采用暴露疗法、催眠等方式,对72例不同程度口腔颌面创伤住院患者进行心理干预．通过SCL-90症状自评清单对患者干预前后的心理状态进行评估,采用SPSS18．0软件包对数据进行统计学分析。结果：干预前,口腔颌面创伤患者SCL-90因子得分普遍高于常模（P〈O．001）．干预后创伤患者的心理健康水平与常模无显著差异。不同创伤严重等级患者心理干预效果差异显著（P〈0．001）,性格因素对干预效果的影响在强迫、人际关系、抑郁和偏执4个因子上差异显著。结论：心理干预的效果与性格因素有关,早期心理干预对内向性格类型的口腔颌面创伤患者的治疗效果优于外向性格类型的患者：创伤严重程度对心理干预的影响与性格因素有关。     

灼口综合征患者心理状态分析及临床心理护理措施

目的探讨灼口综合征（burning mouth syndrome,BMS）患者的心理状态与护理措施。方法 150例BMS患者,针对其不同的心理问题和心理要求进行心理护理。主要措施包括：倾听、告知、鼓励。结果患者消除了焦虑、抑郁、恐癌等反常心理和伸舌自检等不良习惯,以良好的心态配合治疗,150例患者中有139例（92.7%）自觉症状减轻,其中90例（60.0%）症状完全消失。结论通过心理护理,改善BMS患者的心理状态和行为方式,可以减轻症状和提高治疗效果。     

口腔种植围手术期心理护理分析

选择2010年1月至2012年12月在我院口腔种植科患者360例,其中男性206例,女性154例,涉及上颌窦提升手术86例,植骨术64例.按患者就诊顺序给每位患者编号,奇数患者为心理护理组,偶数患者为对照组,每位患者初次就诊心理护理前和心理护理后（术后24h）分别填写改良牙科焦虑量表（modified dental anxiety scale,MDAS）[1],评估患者牙科焦虑情况.MDAS由4个问题条目组成,每条目5个备选答案,分值1-5分,4题选项分数之和为MDAS得分,MDAS评分≥1 1分可诊断为牙科焦虑症.     

60例老年颌面外伤患者的心理特点及疏导

目的:了解颌面外伤老年患者的心理特点,提出相应的心理疏导对策。方法:选择60例老年颌面外伤住院患者,通过临床观察和语言交流,了解他们不同的心理状态,采取相应的心理疏导措施,观察对老年患者医疗活动所起的意义。结果:通过对老年颌面外伤患者心理状态的了解,使用相应的心理疏导对策,对患者的医疗过程和治疗效果可以起到积极的作用。结论:对老年颌面外伤患者除了积极的医疗救助外,还应进行适当的心理疏导。     

Psychological consequences of maxillofacial trauma: a preliminary study

AIMS: To identify the prevalence of post-traumatic psychological symptoms after maxillofacial trauma and prognostic factors related to poor outcome. METHODS: Thirty-nine patients were assessed within 10 days of injury and 24 again 4-6 weeks later using five standardised self-report measures on each occasion and a short structured interview at the time of initial contact. RESULTS: Specific post-traumatic psychological symptoms were present at initial assessment in 21 patients (54%), with 9 (41%) meeting diagnostic criteria for post-traumatic stress disorder at review 4-6 weeks later. Other psychiatric problems, such as anxiety and depression, were identified by the General Health Questionnaire and the Hospital Anxiety and Depression Scale. Characteristics associated with poorer outcome included: a previous history of psychological distress; fear of the unknown, and female sex. CONCLUSION: These findings highlight the adverse psychological effect of maxillofacial trauma both immediately after the event and 4-6 weeks after injury. Proper assessment of injured patients must include psychological aspects and further research is needed to identify the most appropriate response.     

5762例非住院颌面部外伤患者回顾分析

目的: 了解颌面部外伤非住院患者的流行病学特点,为预防和治疗颌面部外伤提供参考。方法: 选取2014年1月—2017年12月于中国医科大学附属盛京医院就诊的5762例非住院颌面部外伤患者进行流行病学统计分析。结果: 非住院颌面部外伤患者中,男性多于女性,男女比例为1.736∶1。发病年龄高峰为学龄前儿童（3~6岁,28.55%）,其次为婴幼儿（0~3岁）。未成年患者（0~17岁）占非住院颌面部外伤患者的68.7%。摔伤（72.9%）为最主要的损伤原因,其次分别为交通事故伤（9.2%）和暴力伤（7.5%）。第3季度（30.1%）及9月份（12.9%）为发病高峰。软组织伤中,额部（37.24%）为最常见的损伤部位,其次为颊部（19.04%）及唇部（18.67%）。结论: 非住院颌面部外伤患者以男性多见,3~6岁组为发病高峰。摔伤及额部是最常见的损伤原因及损伤部位。     

Psychosocial Support Following Maxillofacial Trauma and its Impact on Trauma Recurrence

Background

Injuries sustained to the maxillofacial region can result in significant physical trauma and long lasting psychosocial impairment. Maxillofacial trauma has been reported in literature to be a potentially recurrent disease. Patients who suffer maxillofacial trauma can benefit from psychological support.

Aim

This study aims to identify maxillofacial trauma patient characteristics, investigate maxillofacial re-injury rate after provision of psychological support and report incidence of post traumatic stress disorder symptoms after maxillofacial trauma.

Method

A total of 100 patients were identified from the departmental trauma database over two time periods at Royal Darwin Hospital; 50 patients did not have psychosocial intervention and 50 patients received intervention. Data on demographics, trauma pattern and aetiology were collected. A brief counselling session was conducted on second patient group by a trained mental health nurse and a survey using Trauma Screening Questionnaire was completed one month following injury.

Results

The most common cause of injuries was assault in both groups followed by falls and the most common site of injuries was in the mandible in both groups. Almost half of all patients were in the15–24 and 25–34 age groups. 17 % of patients in pre-intervention period and 4 % of patients in intervention period had injury recurrence at 3 year follow up. Patient groups at risk of developing post traumatic symptoms included male, non-indigenous population, employed group with no alcohol involvement.

Conclusion

Maxillofacial trauma can cause considerable psychological morbidity and expose the patient to high risk of post traumatic disorder symptoms. This type of injury was found to affect particular groups of population and is associated with high rate of recurrence. Psychological support should be provided to these patients as a routine part of trauma aftercare.

     

Quality of life following maxillofacial trauma in the elderly: a multicenter,prospective study

Background/aims

When facial trauma involves elderly patients, the possible presence of frailty and comorbidities in victims of trauma may worsen the posttraumatic symptoms and decrease quality of life. The aim of this multicenter study was to assess the quality of life following surgical or non-operative management of maxillofacial trauma in elderly patients.

Materials and methods

This cohort study was based on the administration of validated self-administered questionnaires to all the geriatric patients (70 years or more) with facial fractures from the involved maxillofacial surgical units across Europe, since 1st January 2019 to 31st June 2019. The following questionnaires were administered: SF36 questionnaire; the VFQ-25 questionnaire; the Oral Health Impact Profile – 14 (OHIP14). Outcome variables were VFQ-25 and OHIP-14 results.

Results

A total of 37 patients (14 male and 23 female patients) met the inclusion criteria and were included in the study. Elderly patients had an improvement in almost all the categories examined by the SF-36 questionnaire 6 months after trauma, with the only exception of a worsening as for role limitations due to physical health. An improvement was observed in almost all the categories at SF-36 test. A worsening of scores of OHIP-14 for all the considered dimensions in the whole study population was observed too.

Conclusions

Elderly patients following facial trauma experience significant emotional, social, and functional disturbances. We observed that emotional problems, energy/fatigue, social functioning, and generally social limitations played a great role in the decrease of QoL in elderly patients following maxillofacial trauma.

     

Does a "hub and spoke" maxillofacial trauma service affect management decisions?

AIM: Using mandibular fractures (excluding those of the condyle) as a model, to find out how management is influenced by whether patients present at the "hub" or "spoke" of a maxillofacial trauma service. MATERIALS: Data on non-condylar mandibular fractures from a maxillofacial trauma database over a 5-year period. RESULTS: Significantly more non-condylar mandibular fractures were treated conservatively in patients who presented at the peripheral spoke hospitals than in those who presented at the hub hospital, despite the populations being similar. CONCLUSION: Geographical presentation of a patient with a non-condylar mandibular fracture in a hub and spoke maxillofacial trauma service influences management decisions.     

口腔颌面部创伤111例患者的伤情分析

目的:总结和探讨"7·23"重特大动车事故发生后一线医院收治的口腔颌面部创伤患者的伤情特点。方法 :对温州市11家医院收治的111例动车事故中口腔颌面部创伤患者的病例资料进行统计和分析。结果:111例口腔颌面部创伤患者中男女比例为1.27∶1;21～30岁(33.3%)为受伤高峰年龄段。在颌面部创伤中,颌面部软组织伤占81.1%,颌面部骨折占11.7%,牙外伤(牙槽突创伤)患者占7.2%。3例下颌骨骨折患者共发生5处骨折,占骨折的29.4%,发生率最高。合并损伤多发,以四肢损伤和胸部损伤最为多见,分别占31.1%和25.7%。结论:动车事故中口腔颌面部创伤多发,但以软组织伤最为常见,颌骨骨折中下颌骨骨折居多;复合伤多,最常见的是四肢和胸部的损伤。