根管治疗转诊病例的分析评估

目的通过对根管治疗转诊病例的分析，为建立完善的根管治疗转诊制度提供临床依据。方法随机选取2011年4-6月转诊到四川大学华西口腔医院牙体牙髓病科行根管治疗的312例患者的355颗患牙为研究对象，调查问卷方式记录患者的信息，评估根管治疗难度及转诊原因。结果355颗转诊患牙中，最多的为下颌第一磨牙（17%），
转诊原因中比例最大的是根管钙化（30%），其次是根管再治疗（24%）。72%的患牙的根管治疗难度为Ⅲ度，治疗难度为Ⅰ度的仅占7％。不同来源患者的治疗难度间的差异无统计学意义（P=0.9）。结论建立完善的根管治疗转诊制度需要每位医生的配合，治疗前应首先评估根管治疗难度以确定治疗或转诊，根据治疗难度分诊至不同层次的医生进行治疗。

Assessment of referral cases for root canal therapy

Objective To assess referral cases for root canal therapy to provide clinical evidence with establishment of referral system. Methods A questionnaire was designed to collect 312 cases（355 teeth） referred to Department of Conservative Dentistry and Endodontics, West China School of Stomatology, Sichuan University for root canal therapy from April to June in 2011. The questionnaire consisted of questions such as age, gender, occupation, general disease and medical histories of patients, sources. Difficulty of treatment before therapy and reasons for referral were evaluated. Results In 355 referral teeth, the most were mandibular first molars（17%）, the greatest percentage of reasons were calcified root canals（30%）, the second was root canal retreatment（24%）. 72% of teeth belong to the complicated difficulty（Class Ⅲ）, while 7% were listed as the uncomplicated difficulty（Class Ⅰ）. No significantly difference from different sources was found（P=0.9）. Conclusion Establishment of referral system needs cooperation with every dentist. Difficulty of cases for root canal therapy before treatment should be first evaluated to treat or to refer. Referral cases for root canal therapy should be treated by endodontist of corresponding level according to the difficulty.