アブストラクト（37巻4号：神奈川歯学）

神奈川歯学

Japanese

Title　： 当科における入院抜歯症例の検討
Subtitle　：
Authors　： 本間義郎, 河合良明, 鎌田仁*, 河原健司, 土肥雅彦, 笹倉裕一*, 新藤潤一*, 久保田英朗
Authors（kana）　：
Organization　： 神奈川歯科大学囗腔外科学教室第二講座, *神奈川歯科大学囗腔外科学教室第一講座
Journal　： 神奈川歯学
Volume　： 37
Number　： 4
Page　： 150-157
Year/Month　： 2002 / 12
Article　： 報告
Publisher　： 神奈川歯科大学学会
Abstract　： これまで抜歯を始めとする口腔外科小手術の侵襲は適切に評価されず, 専ら外来通院で行われていた. Goldbergら1)は下顎智歯500歯が抜去された302例中21例, 4. 2%に術後感染がみられ, そのうち0. 2%は重症例であったと報告している. また大塚ら2)は142例の蜂窩織炎入院例のうち11例が下顎智歯抜去後に発症していたと報告している. 最近, 抜歯の侵襲を正しく評価し, その侵襲に見合った対応に取り組むことが真の患者サービスに繋がると認識されるようになってきた3, 4). すなわち侵襲の大きい抜歯には全身麻酔や鎮静法を応用し, 術後の出血, 疼痛, 栄養の管理目的で短期入院を取り入れる施設が増加している5, 6). また高齢化社会の到来に伴い, 何らかの全身的合併症をもつ患者が歯科医院を受診する機会が多くなっている. さらに週休2日制の定着, 治療期間の短縮, より快適な無痛下での処置を希望する患者側のニーズや社会の変化に伴い, 当科でも入院下で抜歯を行う機会が増加している.
Practice　： 歯科学
Keywords　： 入院, 抜歯, 複数埋伏智歯

English

Title　： Clinical Study of Inpatients for Tooth Extraction
Subtitle　：
Authors　： Yoshiro HONMA, Yoshiaki KAWAI, Hitoshi KAMATA*, Kenji KAWAHARA, Masahiko DOHI, Yuichi SASAKURA*, Jun-ichi SHINDO*, Eiro KUBOTA
Authors（kana）　：
Organization　： Second Department of Oral and Maxillofacial Surgery, Kanagawa Dental College, *First Department of Oral and Maxillofacial Surgery, Kanagawa Dental College
Journal　： Kanagawa Shigaku
Volume　： 37
Number　： 4
Page　： 150-157
Year/Month　： 2002 / 12
Article　： Report
Publisher　： Kanagawa Odontological Society
Abstract　： Between 1994 and 2000, of the 2,192 patients hospitalized at the Kanagawa Dental College Hospital, 316 patients (14.4%) who had undergone tooth extractions were chosen as a sample for the present study. In the sample, females exceeded males in the ratio of 1.8 to 1 and the average age of the sample was 36.6 years. The most common reason for hospitalization was for the extraction of multiple impacted third molars (159 cases). Other common causes were technical difficulties in extractions (53 cases), cardiovascular complications, anxieties over treatment and a need to extract many teeth at the same time. With regard to the type of anesthetic used, 60% of the patients were treated with a general anesthetic. Of the patients who were treated with a local anesthetic, 20% were given an intravenous sedative, 14% used no sedatives at all and 5% were also given an inhalation sedative with nitrous oxide and oxygen. The length of the hospitalization varied ; most patients (29%) stayed for 2 days and 87% stayed for 5 days or less. With regard to the average length of hospitalization in relation to the type of anesthetic, patients who had general anesthesia stayed for an average of 4.5 days. Those patients who were given an intravenous sedative stayed for 2.4 days, patients who were given an inhalation sedative stayed for 3 days and patients who were given no sedatives stayed for an average of 3.3 days. There are indications that some drawbacks might be connected with hospitalization for the extractions, such as complication for preoperative examination and increased medical costs. However, there are also potential merits involved in undergoing treatment with hospitalization ; e.g. a ready availability of safe and reliable procedures, prompt measures available for discomfort following an operation, shortening of the treatment time, and proper application of antibacterial agents.
Practice　： Dentistry
Keywords　：