基于快速康复外科理念的医护一体化全程护理对先天性巨结肠手术患儿康复进程、术后疼痛程度、并发症发生率的影响

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目的 分析基于快速康复外科(ERAS)理念的医护一体化全程护理在先天性巨结肠手术患儿中的护理效果。方法 回顾性选取我院97例HSCR手术患儿(2018年5月—2025年7月)作为研究对象,依照护理模式不同分为对照组(49例)、观察组(48例)。对照组采用常规护理干预,观察组在上述基础上采用基于ERAS理念的医护一体化全程护理。比较2组术后恢复情况、并发症发生率、疼痛程度[FLACC疼痛评分法(FLACC)]、家属照护能力[家属照顾者照顾能力测量表(FCTI)]、家属满意度。结果 干预后,观察组胃管拔除时间、尿管拔除时间、肛管拔除时间、经口进食时间、术后首次排便时间、术后排气时间、肠鸣音恢复时间与住院时长均显著短于对照组,FCTI得分显著低于对照组(P<0.05);干预后,观察组并发症发生率显著低于对照组,家属护理满意度高于对照组(P<0.05);术后3d、7d,观察组FLACC得分均显著低于对照组(P<0.05)。结论 基于ERAS理念的医护一体化全程护理可缓解HSCR手术患儿疼痛程度,提高家属照护能力,降低并发症发生率,促进术后恢复,提升家属满意度。

新型光固化Theracal LC盖髓剂对乳牙牙髓切断术患儿治疗成功率、疼痛程度、咀嚼功能、龈沟液炎性因子、牙根吸收程度、牙本质桥形成的影响

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Objective To investigate the clinical application value of novel light-cured TheraCal LC pulp capping agent in children receiving deciduous teeth pulpotomy. Methods A retrospective study was performed on clinical data of 90 children who underwent deciduous teeth pulpotomy from August 2023 to May 2025. Subjects were divided according to different capping materials: 45 cases using TheraCal LC as study group, another 45 cases treated with iRoot BP Plus as control group. The treatment success rate, pain score, masticatory efficiency, gingival crevicular fluid inflammatory factors [interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3)], root resorption, dentin bridge formation and adverse reactions were compared between two groups. Results There was no significant difference was found in treatment success rate at 12 months after operation between groups (P>0.05). At postoperative 3 months, the study group had lower pain score and higher masticatory efficiency than the control group (P<0.05), whereas no intergroup differences were observed at 6 and 12 months (P>0.05). The levels of gingival crevicular fluid IL-6 and MMP-3 in study group were significantly lower at 3, 6 and 12 months postoperatively (P<0.05). There was no significant difference in root resorption degree and dentin bridge formation rate at postoperative 12 months (P>0.05). No pulp inflammation, tooth discoloration or secondary caries occurred in either group. Conclusion The novel light-cured TheraCal LC shows favorable overall efficacy and safety in deciduous teeth pulpotomy; it can effectively suppress early gingival inflammation, relieve early postoperative pain and improve early masticatory function.

3M复合树脂填充治疗对乳牙龋齿患儿临床疗效、疼痛程度、牙髓活力、牙齿敏感性、龈沟液炎症因子、口腔健康评分的影响

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目的 探讨3M复合树脂填充乳牙龋齿患儿治疗中的临床价值。方法 回顾性收集2023年4月至2025年4月我院口腔科128例乳牙龋齿患儿临床资料,根据治疗方法不同分为对照组(高强度玻璃离子填充,67例)、观察组(3M复合树脂填充,61例),采用倾向匹配评分法匹配,按照1:1配对选例,两组均纳入53例。比较两组疗效、治疗前后疼痛程度[Wong-Baker面部疼痛评分量表(Wong-Baker评分)]、牙髓活力、牙齿敏感性、龈沟液炎症因子[白细胞介素(IL)-6、IL-8、单核细胞趋化蛋白-1(MCP-1)]、儿童口腔健康影响量表(ECOHIS)评分及并发症。结果 观察组治疗总有效率94.34%高于对照组81.13%(P<0.05);治疗后1周观察组Wong-Baker评分、牙髓活力评分低于对照组,牙齿敏感性分级优于对照组(P<0.05);治疗后1周,观察组龈沟液IL-6、IL-8、MCP-1水平低于对照组(P<0.05);治疗后6个月,观察组口腔症状、口腔功能、心理状态评分低于对照组(P<0.05);两组并发症发生率比较,无显著差异(P>0.05)。结论 3M复合树脂填充治疗乳牙龋齿患儿效果显著,能抑制龈沟液炎症,降低牙齿敏感性,提升牙髓活力,缓解患儿疼痛,改善口腔健康,且安全性较高。
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