盐酸戊乙奎醚用于小儿口腔全麻前给药的研究

目的:观察比较盐酸戊乙奎醚(penehyclidine hydrochloride)和阿托品、东莨菪碱用作小儿口腔全麻前用药的临床效果。方法:45例小儿唇裂或腭裂修补手术患儿根据术前用药情况随机双盲分为盐酸戊乙奎醚组(PHE)、阿托品组(ART)和东莨菪碱组(SCO),每组15例,分别在麻醉开始前30min肌注盐酸戊乙奎醚或阿托品、东莨菪碱0.01mg/kg,记录给药前(T0)及给药后10min(T1)、30min(T2)患儿的血压(BP)、心率、脉搏血氧饱和度(SpO2)及T0、T1、T2和气管导管拔除时(T3)患儿面红、腺体分泌情况。结果:3组患儿年龄、性别、体质量均无显著性差异(P>0.05);PHE组术前注药后心率、血压无明显改变(P>0.05),ART组、SCO组注药后心率均明显增快(P<0.01或P<0.05),与PHE组比较有显著性差异(P<0.05);PHE组口干持续时间较ART、SCO2组明显延长,与后2组比较,气管拔管时分泌物量明显减少,且面红发生率较低(P<0.05)。结论:盐酸戊乙奎醚具有显著的心率稳定作用及强大持久的腺体分泌抑制作用,作为术前用药效果满意,优于阿托品和东莨菪碱,可安全用于小儿颌外口内手术麻醉前给药。     

口腔颌面外科术后延迟拔管患者应用盐酸戊乙奎醚的疗效观察

目的:比较观察口腔颌面外科术后肌注盐酸戊乙奎醚和硫酸阿托品对患者口腔、气道腺体分泌的影响,探讨术后肌注盐酸戊乙奎醚的临床疗效。方法:45例美国麻醉医师学会分级Ⅰ～Ⅱ级、术后需要保留气管导管2d的口腔颌面外科手术患者随机分为3组,每组15例,A组为对照组,B组为硫酸阿托品组,C组为盐酸戊乙奎醚组。于术毕以及术后24h分别肌注生理盐水、硫酸阿托品0.5mg和盐酸戊乙奎醚0.01mg/kg。观察术后0～12h、12～24h、24～36h和36～48h各时间段内患者平均每小时口腔、气道分泌物量和不良反应,采用SAS6.12统计软件包进行分析。结果:从平均每小时口腔分泌物量看,给药后前12h内(0～12h和24～36h),B组和C组显著少于A组(P<0.05和P<0.01),C组也显著少于B组(P<0.05);后12h(12～24h和36～48h)内,C组显著少于A组(P<0.05)而B组与A组差异不大(P>0.05)。从平均每小时气道分泌物量看,各时间段C组均显著少于A组和B组(P<0.05);各组均未发生严重不良反应。结论:术后肌注盐酸戊乙奎醚能明显抑制保留气管插管的口腔颌面外科患者口腔、气道腺体分泌,安全有效。     

长托宁、阿托品用于腮腺手术前麻醉给药的临床比较

临床资料 1 一般资料:择期腮腺手术ASAⅠ～Ⅱ级病例40例,随机分成阿托品(A组)和长托宁(B组),每组20例,病人入室后开通静脉输液,监测血压、心率、血氧分压.分别肌注阿托品和长托宁1.0mg,45min内不进行任何麻醉手术操作,并监测注射前15min和30 min、手术结束时4个时段的心率和血压变化;观察患者给药前、给药后的面色、口干程度和抑制唾液分泌情况.     

盐酸戊乙奎醚对接受口腔颌面部手术的老年患者认知功能的影响

目的: 探讨麻醉前应用阿托品以及不同剂量盐酸戊乙奎醚对接受口腔颌面部手术的老年患者术后认知功能的影响。方法: 选择2017年12月—2018年7月于上海交通大学医学院附属第九人民医院择期行口腔颌面部手术的老年患者134例,麻醉诱导前随机接受阿托品0.5 mg（A组,n=32）、盐酸戊乙奎醚0.01 mg/kg（C1组,n=34）、盐酸戊乙奎醚0.015 mg/kg（C2组,n=33）、生理盐水（NS组,n=35）作为术前用药。比较4组患者术前焦虑评分、术前认知功能评分、用药后生命体征变化、口腔腺体分泌程度、手术时间、失血量、苏醒时间、术后疼痛评估、术后认知功能评分。采用SPSS 18.0软件包对数据进行统计分析。结果: A组患者用药后心率变化较其余3组显著升高（P<0.05）,A组、C1组、C2组患者用药后在准备室需要吸引口腔内分泌物次数较对照组显著减少（P<0.05）,C2组苏醒时间较其余3组显著延长（P<0.05）,MMSE评分显著下降（P<0.05）。结论: 麻醉诱导前应用小剂量（0.01 mg/kg）盐酸戊乙奎醚,不延长苏醒时间、不增加术后认知功能下降风险,同时其抑制口腔腺体分泌效果好,对老年患者心肺系统影响较小,是老年口腔颌面部手术患者理想的术前用药。     

戊乙奎醚和托烷司琼联合用药对口腔颌面外科术后恶心呕吐的防治作用

目的:寻找一种对口腔颌面外科术后恶心呕吐有更强防治作用的方法。方法:40例口腔颌面外科手术患者术前用阿托品、手术结束用托烷司琼为A+T组;另40例术前用戊乙奎醚、手术结束用托烷司琼为P+T组。结果:麻醉恢复期24 h内,恶心VAS评分,A+T组高于P+T组(P<0.05);呕吐百分比A+T组明显高于P+T组(P<0.05)。结论:口腔颌面外科手术患者,术前戊乙奎醚、术后托烷司琼的联合用药,能更好地防治术后恶心呕吐。     

口腔颌面外科学：麻醉与手术

咪哒唑仑用于颌面外科手术后留置气管导管患者的临床研究；下颌升枝矢状劈开截骨术对骨性下颌前突舌骨位置和气道宽度的影响；口腔颌面外科术后延迟拔管患者应用盐酸戊乙奎醚的疗效观察；静脉泵入眯达唑仑清醒镇静技术控制牙科恐惧症的临床效果评价；保留自主呼吸全身麻醉用于小儿唇裂手术的安全性探讨     

长托宁在小儿唇腭裂手术麻醉前用药的临床观察

目的比较长托宁、阿托品及东莨菪碱术前肌注对唇腭裂手术全麻患者的效果。方法选择在气管插管全麻下行唇腭裂手术的120例患者为研究对象,将其随机分为长托宁组、阿托品组、东莨菪碱组,每组40例患者。3组患者术前分别肌注长托宁0.01 mg/kg、阿托品0.01 mg/kg、东莨菪碱0.006 mg/kg,观察并记录给药前、给药后15 min、给药后30 min、插管后及术毕拔管时患者的心率、体温、血压及呼吸道分泌物等指标。结果长托宁组患者用药后心率、体温、血压无明显变化（P>0.05）;阿托品组、东莨菪碱组患者用药后心率明显加快、体温升高（P<0.05）,血压无明显变化（P>0.05）。术毕拔管时,长托宁组患者的分泌物较阿托品组、东莨菪碱组明显减少（P<0.05）。结论长托宁作为小儿唇腭裂手术前用药对心率、体温、血压无明显影响,对呼吸道腺体分泌有持久的抑制作用,优于阿托品与东莨菪碱。     

瑞芬太尼复合七氟醚在口腔颌面外科手术中的应用

［摘要］ 目的 观察瑞芬太尼-七氟醚静吸复合麻醉与瑞芬太尼-丙泊酚全凭静脉麻醉在口腔颌面外科手术中的应用。方法 40例ASAⅠ~Ⅱ级患者,择期行口腔颌面外科手术,随机分为瑞芬太尼-七氟醚组(S组)和瑞芬太尼-丙泊酚组(P组),每组20例。记录围麻醉期各时点的血流动力学变化,及唤醒时间、拔管时间和苏醒期的不良反应,比较两组瑞芬太尼使用总量。结果 2组病例术中麻醉效果满意,诱导前、诱导后、手术开始后30 min和术毕的平均压、心率组间比较差异无显著性(P>0.05)。S组瑞芬太尼使用总量较P组低,差异有显著性(P<0.05)。两组患者在手术结束后均能快速苏醒,S组与P组的停药到唤醒时间和拔管时间比较差异无显著性(P>0.05)。但S组患者在苏醒期躁动反应发生率高于P组(P<0.05)。结论 瑞芬太尼复合七氟醚可以安全、有效的运用于口腔颌面外科手术中。     

口腔颌面外科学麻醉与手术

改良半面掀翻径路加睑缘灰线切口行上颌骨全切除术的效果评价；颌骨骨折坚强内固定术97例应用体会；静脉麻醉下儿童埋伏多生牙拔除的临床总结；髁突骨折两种手术方法的比较；盐酸戊乙奎醚用于小儿口腔全麻前给药的研究     

复方利多卡因乳膏在儿童口腔颌面表浅小手术中的应用

目的：探讨复方利多卡因乳膏在儿童口腔颌面表浅小手术中应用的效果。方法：72例5～12岁口腔颌面表浅小手术患儿平均分为两组,分别给予复方利多卡因软膏表面麻醉和盐酸利多卡因注射液局部浸润麻醉,运用Wong—Baker面部表情分级量表比较两组麻醉时和手术时的疼痛情况。结果：使用复方利多卡因软膏组的患儿在实施麻醉过程中,疼痛评分明显低于盐酸利多卡因注射液组,而在手术过程中两组的疼痛评分没有统计学差异。结论：复方利多卡因软膏可以应用于儿童口腔颌面表浅小手术的表面麻醉。     

Diagnosis and management of hemangiomas and vascular malformations of the head and neck

Oral Diseases (2010) 16 , 405–418 Vascular anomalies are congenital errors in vascular development. They frequently involve the head, neck, and oral cavity. Subdivided into vascular tumors (hemangiomas) and vascular malformations, vascular anomalies remain poorly understood. However, growing interest and recent advances in the diagnosis, management, and molecular characterization of these lesions are improving treatment strategies. The role of the multidisciplinary team cannot be overstated. This review provides both basic and up‐to‐date knowledge on the most common vascular anomalies encountered by physicians and practitioners. Because treatment options for vascular anomalies are widely variable and often debated, this report aims to provide a comprehensive approach to these lesions based upon current concepts and practical clinical experience.     

口腔颌面-头颈部胚胎型横纹肌肉瘤临床诊治探讨

目的:探讨头颈部胚胎型横纹肌肉瘤的临床特点、诊断、治疗及预后.方法:回顾性分析上海交通大学医学院附属第九人民医院2000-09--2010-10收治的12例头颈部胚胎型横纹肌肉瘤患者的临床资料.结果:12例患者中9例获得随访.5例术前化疗患者中3例短期疗效达到PR,1例达到MR,化疗有效率达到60%;8例患者行手术治疗...     

Colour and translucency of opaque-shades and body-shades of resin composites

The purpose of this study was to evaluate the optical properties--not only the translucency but also the colours--of opaque-shade resin composites. The CIELAB parameters (L*, a* and b*) of disks of A2 and opaque A2 (OA2) shades of Charisma (Heraeus-Kulzer), Solare (GC) and Filtek Supreme (3M) were evaluated on backings of black, white and the material itself to calculate the translucency parameter (TP) and the colour differences (delta E*) between A2 and OA2. A two-way analysis of variance (anova) for the TP indicated a less statistically significant TP value in the OA2 shade than the A2 shade for all products. As for the products, Charisma showed a statistically greater TP value than the other two products. Regarding the delta E* between A2 and OA2, all the products revealed clinically perceptible colour differences (delta E* > 3.3). Hence, we must take the colour differences of opaque-shade resin composites into consideration, as well as the translucency of the materials, for a clinically acceptable colour match of the restoration.     

种植体周围炎与牙周炎的类比探究

种植体周围炎症是种植失败的主要原因之一,包括种植体周围黏膜炎和种植体周围炎。种植体周围炎的发生、发展及治疗和预防与牙周炎存在一定的相似性,本文将种植体周围炎和牙周炎的流行病学、组织病理表现、始动因素、危险因素、治疗和预防等方面进行类比,探讨如何更好地预防和治疗种植体周围炎。     

Assessment and comparison of phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non-smokers

OBJECTIVES

Tobacco use is one of the most important public health problems worldwide. It is also linked to impairment of normal immunologic surveillance and defence mechanism of polymorphonuclear leukocytes. Tobacco smoke and its components have been seen to affect the phagocytic ability and viability of polymorphonuclear leukocytes suggesting the pathogenesis of tobacco induced oral diseases. Aim of this study was to assess and compare the phagocytic function and viability of polymorphonuclear leukocytes in saliva of smokers and non smokers.

DESIGN

The study comprised of 35 smokers and 35 non-smokers, age matched. Saliva was collected by rinsing method and the polymorphonuclear leukocytes were separated. Phagocytic activity was determined by using latex spheres as targets. Cell viability was measured using trypan blue stain.

RESULTS

Salivary polymorphonuclear leukocytes in smokers showed significant reduction in the phagocytic activity by ingesting few latex spheres when compared to the non-smokers. The viability of these cells in saliva of smokers was significantly reduced.

CONCLUSIONS

The present study revealed reduced phagocytic activity and viability of salivary polymorphonuclear leukocytes in smokers compared to non-smokers. These findings indicate that smokers are more prone to gingival, periodontal and other oral diseases. Thus indicating that the health care professionals should encourage smoking cessation as an aid in preventing oral diseases.     

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牙拔除术是一种常见的外科手术,术后因机体对拔牙创伤的生理反应会不可避免地引起局部出现程度不一的疼痛、肿胀,这种由手术创伤引起的疼痛、肿胀虽然是正常手术的继发过程,但会导致患者术后生活质量下降,并可使很多由于恐惧而不敢拔牙的患者延误了最佳治疗时机。本文就拔牙术后疼痛和肿胀的发生原因、临床表现、治疗方法和预防措施进行阐述,为临床上如何避免或减轻拔牙术后的疼痛和肿胀提供帮助。     

Combined effects of NaF and SLS on acid- and polysaccharide-formation of biofilm and planktonic cells

Bacteria grow preferentially attached to surfaces embedded in an exopolysaccharide matrix to form biofilms. In this mode of growth, bacteria often show reduced susceptibility to antimicrobials. The aim of this study was to investigate whether the combination of NaF and the detergent sodium lauryl sulphate (SLS) could result in additive effects on acid formation by planktonic and biofilm cells, as well as on extracellular polysaccharide formation. An additive inhibitory effect on Streptococcus mutans acid formation was observed, both in planktonic and biofilm cells. In dental biofilms, SLS alone and in combination with NaF reduced acid formation. Extracellular polysaccharide formation by S. mutans and saliva was reduced by SLS alone and in combination with NaF. In dentifrices and mouthrinse solutions, NaF and SLS are often present in combination. It remains to be determined whether an additive effect on acid formation may also occur in dental biofilms under different concentrations from those used in the present study, and whether the effects may be selective for certain bacterial species.     

Effects of zinc and copper on adhesion and hemagglutination of Prevotella intermedia and Prevotella nigrescens

This study investigated the mechanism of protein attachment to the surface of the putative periodontal pathogens Prevotella intermedia and Prevotella nigrescens in artificial gingival crevicular fluid, and ways to increase protein attachment to the bacterial cells. The effects of cations on protein attachment, bacterial adhesion, and hemagglutination were examined, and cation-binding components on both bacterial species were identified. The presence of cations, especially zinc, copper and cerium, increased attachment of human serum proteins to both bacterial species. In contrast, the presence of hydrophobic inhibitors or sugars had little effect. Protein attachment was reduced by heat treatment of the bacterial cells. Pretreatment of bacteria with human serum proteins inhibited adhesion of both species to buccal epithelial cells and hemagglutination. These effects were enhanced by the presence of zinc and copper during pretreatment. Using a chelating column, specific zinc- and copper-binding proteins were identified on the surfaces of both bacterial species.     

Impact of moderate and severe hypodontia and amelogenesis imperfecta on quality of life and self-esteem of adult patients

ObjectivesThe objective of this study was to investigate the impact of moderate and severe hypodontia and amelogenesis imperfecta on the quality of life and self-esteem of affected adult patients.MethodsForty one adult patients (aged 18–45 years) with clinical and radiological diagnoses of moderate to severe hypodontia and twenty seven patients diagnosed with amelogenesis imperfecta were age and gender matched with a control group of patients attending for routine dental care. Subjects completed the Oral Health Impact Profile [OHIP-49] and Rosenberg Self Esteem Scale. A paired t-test was used to analyse data; the test alpha level was set at P ≤ 0.05.ResultsThe results for hypodontia patients were significantly different from controls in six out of the seven OHIP-49 domains, the exception being the Handicap domain. Total scores were also significantly different between the two groups (P = 0.003). Self-esteem was not significantly different between the two groups (P = 0.98).For amelogenesis imperfecta patients the results were significantly different from control patients in four out of the seven domains of the OHIP-49 and also in the total scores (P = 0.01). When self-esteem was investigated there was no significant differences between the two groups (P = 0.92).ConclusionsModerate to severe hypodontia and amelogenesis imperfecta have marked negative impacts on the Oral Health Related quality of life of this patient population relative to controls. However, self-esteem was not significantly affected.