CAJ | 학술논문

目的：评价不合作患儿在全身麻醉下或束缚下进行牙科治疗后，其牙科畏惧水平及就诊行为的变化。方法：全身麻醉组为全身麻醉下进行牙科治疗的4～6岁重度牙科畏惧症患儿31例，束缚组为在性别、年龄、治疗前焦虑水平、口腔内龋坏情况与全身麻醉组严格匹配的在束缚下进行牙科治疗的患儿31例。应用MCDASf （ face ver-sion of the Modified Child Dental Anxiety Scale ， MCDASf）中文版量表评价两组患儿治疗前、治疗后和2～3周复诊时主观畏惧水平的变化，同时评价两组患儿治疗时和复诊时的临床就诊行为变化。结果：全身麻醉组治疗后、复诊前MCDASf 中文版量表平均得分较治疗前下降，差异均有统计学意义。束缚组治疗后、复诊前MCDASf 中文版量表平均得分均较治疗前略上升，但差异无统计学意义。两组间MCDASf 中文版量表治疗前、后变化的差异有统计学意义。全身麻醉组患儿经全身麻醉治疗后复诊时的临床就诊行为表现较治疗时的临床就诊行为表现有所改善，两者差异有统计学意义（P＜0．01）。束缚组治疗后复诊时的临床行为表现较束缚治疗时的临床就诊行为有所改善，差异有统计学意义（P＜0．01）。结论：全身麻醉下牙科治疗能够缓解牙科畏惧症患儿就诊中的焦虑、恐惧情绪，提高患儿治疗的合作性，改善其短期复诊的就诊行为。束缚下牙科治疗后患儿的牙科畏惧水平略有增高，但差异无统计学意义，短期复诊时的就诊行为表现有所改善。
목적：평개불합작환인재전신마취하혹속박하진행아과치료후，기아과외구수평급취진행위적변화。방법：전신마취조위전신마취하진행아과치료적4～6세중도아과외구증환인31례，속박조위재성별、년령、치료전초필수평、구강내우배정황여전신마취조엄격필배적재속박하진행아과치료적환인31례。응용MCDASf （ face ver-sion of the Modified Child Dental Anxiety Scale ， MCDASf）중문판량표평개량조환인치료전、치료후화2～3주복진시주관외구수평적변화，동시평개량조환인치료시화복진시적림상취진행위변화。결과：전신마취조치료후、복진전MCDASf 중문판량표평균득분교치료전하강，차이균유통계학의의。속박조치료후、복진전MCDASf 중문판량표평균득분균교치료전략상승，단차이무통계학의의。량조간MCDASf 중문판량표치료전、후변화적차이유통계학의의。전신마취조환인경전신마취치료후복진시적림상취진행위표현교치료시적림상취진행위표현유소개선，량자차이유통계학의의（P＜0．01）。속박조치료후복진시적림상행위표현교속박치료시적림상취진행위유소개선，차이유통계학의의（P＜0．01）。결론：전신마취하아과치료능구완해아과외구증환인취진중적초필、공구정서，제고환인치료적합작성，개선기단기복진적취진행위。속박하아과치료후환인적아과외구수평략유증고，단차이무통계학의의，단기복진시적취진행위표현유소개선。
Objective:To compare the level of dental anxiety and dental behavior between dental fear children with dental treatment under general anaesthesia ( GA) and those under restraint .Methods:The GA group included 31 dental fear children aged 4-6-year-old who received dental treatment under the GA.The restraint group included 31 dental fear children aged 4-6-year-old who received dental treat-ment under the restraint.Age, gender, parent’s education level, decayed-missing-filled tooth (dmft) and face version of the Modified Child Dental Anxiety Scale ( MCDASf ) score before treatment were matched between the two groups .The Chinese version of MCDAS f was used to evaluate the level of dental anxiety in each child before treatment , right after treatment and before examination at recall visit 2 -3 weeks after treatment .And the Chinese version of Venham Clinical Anxiety and Cooperative Behavior Scale was used to evaluate children ’ s dental behavior in each child before treatment and before examina-tion at recall visit 2-3 weeks after treatment .Results:The average scores of MCDAS f in GA group right after treatment and before recall were lower than that before treatment .The difference was statistically sig-nificant (P<0.05).Furthermore, the average score of MCDASf before recall was lower than those after treatment, and the difference was statistically significant (P<0.05).The average scores of MCDASf in restraint group right after treatment and 2-3 weeks after treatment were higher than those before treat-ment , but the difference was not statistically significant ( P>0 .05 ) .Children ’ s dental behavior was sig-nificantly improved at recall visit in both groups (P<0.01).Conclusion:Dental fear could be reduced by treatment under GA .The children ’ s dental behavior was improved after GA .Restraint did not result in the significant elevation of dental anxiety level , but dental behavior was improved after restraint during the short-term recall.