Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 342-349.doi: 10.24920/003708

• 论著 • 上一篇    下一篇

牙科诊室医学急症:来自2013位中国口腔医生的调查分析

景泉,万阔(),马林,赵继志   

  1. 北京协和医院口腔科 中国医学科学院 北京协和医学院,北京 100730,中国
  • 收稿日期:2020-01-05 接受日期:2020-03-23 出版日期:2020-12-31 发布日期:2021-01-08
  • 通讯作者: 万阔 E-mail:wankuo@126.com

Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China

Quan Jing,Kuo Wan(),Lin Ma,Jizhi Zhao   

  1. Department of Dentistry, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2020-01-05 Accepted:2020-03-23 Published:2020-12-31 Online:2021-01-08
  • Contact: Kuo Wan E-mail:wankuo@126.com

摘要:

目的 调查分析中国牙科诊室医疗急症的特征、发生频率,以及牙科医生经历医疗急症的相关风险因素。
方法 对2015年12月至2018年12月期间参加在中国18个城市举行的中华口腔医学会镇静镇痛学会继续教育课程的2408名牙医进行问卷调研,收集牙医个人及职业信息,过去三年行医中是否遇到医学急症、以及其相关特征信息,分析发生在牙科诊室的医疗急症的特点和牙科医生行医过程遭遇医学急症的相关风险因素。
结果 共有2013位牙医提供了有效问卷,报告了2923次发生在口腔诊室的医学急症事件。85.0%的牙医报告在过去三年遇到过医学急症,35.5%的牙医至少遇到过2次医学急症。其中晕厥(35.9%)和低血糖(30.3%)是最常见的急症类型。医疗急症最常见发生于口腔局部麻醉(49.9%)、门诊口腔手术(25.9%)和根管治疗(11.3%)操作中。医疗急症导致死亡共6例(0.2%)。有84.0%的牙医报告从未接受过除基础生命支持以外的口腔急症急救的课程培训。较长的职业生涯(10~15年)(OR = 0.59, 95% CI: 0.41~0.85, P=0.004)、在私立的牙科诊所或医院工作(OR = 1.69, 95% CI: 1.20~2.38, P=0.003)等因素与牙医经历医学急症的风险增加相关。
结论 应加强牙医对医学急症的预防、早期发现和及时正确处理的能力培养,以减少严重医疗安全事件发生。本调查结果可作为重新设计口腔急救培训课程之参考。

关键词: 牙科诊室, 牙科医生, 医学急症, 发生频率, 调查

Abstract:

Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the associated factors for Chinese dentists experiencing medical emergencies.
Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018. Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed. The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.
Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics. Among them, 85.0% reported that they had encountered medical emergencies, and 35.5% had encountered at least twice. Syncope (35.9%) and hypoglycemia (30.3%) were the most common reported medical emergencies. Medical emergencies were most likely to occur during local anesthesia (49.9%), out-patient oral surgery (25.9%), and root canal treatment (11.3%). There were 6 patients (0.2%) died in emergencies. 84.0% dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support. Longer practicing time (10-15 years) (OR=0.59, 95% CI: 0.41-0.85, P=0.004), working in private dental facilities (OR=1.69, 95% CI: 1.20-2.38, P=0.003) were associated with an increased risk of experiencing medical emergencies.
Conclusion More efforts are needed in prevention, early identification, and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes. The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.

Key words: dental clinics, dentists, medical emergency, frequency, survey

基金资助: 北京协和医学院“青年教育学者”培养计划(2016zlgc0712)

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