重度低龄儿童龋儿童全身麻醉与常规门诊下牙病治疗的疗效及卫生经济学评价

doi:10.7518/hxkq.2021.06.012

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (6): 703-708.doi: 10.7518/hxkq.2021.06.012

重度低龄儿童龋儿童全身麻醉与常规门诊下牙病治疗的疗效及卫生经济学评价

刘亚琪¹(), 张琼¹, 王艳¹, 瞿星², 邹静¹()

^1.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院儿童口腔科，成都 610041
^2.四川大学华西医院医院管理研究所，成都 610041

收稿日期:2021-02-03 修回日期:2021-09-07 出版日期:2021-12-01 发布日期:2021-12-03
通讯作者: 邹静 E-mail:liuyaqi516@foxmail.com;zoujing@scu.edu.cn
作者简介:刘亚琪，硕士，E-mail：liuyaqi516@foxmail.com
基金资助:
四川省国际科技创新合作项目(2019YFH0025);成都市科学技术局技术创新研发项目(2021YF0501980SN)

Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries

Liu Yaqi¹(), Zhang Qiong¹, Wang Yan¹, Qu Xing², Zou Jing¹()

^1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, China

Received:2021-02-03 Revised:2021-09-07 Online:2021-12-01 Published:2021-12-03
Contact: Zou Jing E-mail:liuyaqi516@foxmail.com;zoujing@scu.edu.cn
Supported by:
the Innovation and Collaborative Project of Science and Technology Department of Sichuan Province(2019YFH0025);the Technological Innovation Research and Development Project of Chengdu Bureau of Science and Technology(2021YF0501980SN)

摘要/Abstract

摘要： 目的

对牙科全身麻醉（DGA）下和常规门诊治疗的重度低龄儿童龋（S-ECC）进行临床疗效及卫生经济学评价，为医生和家长的临床治疗方案选择提供参考。

方法

对接受DGA下牙病综合治疗或常规门诊治疗的36~71月龄S-ECC儿童进行回顾性队列研究，比较两组患儿的充填牙生存率、治疗成本以及成本—充填牙生存时间比并进行疗效和卫生经济学评价。

结果

DGA组患儿充填牙生存率高于常规门诊组（P<0.05）。DGA组平均每颗充填牙的直接医疗成本、直接医疗成本—生存时间比显著高于常规门诊组（P<0.05），但两组间总医疗成本—生存时间比差异无统计学意义（P>0.05）。

结论

相比于常规门诊治疗，DGA下治疗S-ECC较常规门诊成本更高，疗效更好，二者成本—效果比相当，常规门诊治疗并不具有明显的的经济优势。

关键词: 重度低龄儿童龋, 牙科全身麻醉, 生存分析, 成本, 卫生经济学

Abstract: Objective

To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment.

Methods

A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated.

Results

The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (P<0.05). The average direct medical cost per filled tooth was significantly higher in the DGA group than in the routine outpatient group (P<0.05). The direct medical cost-filled tooth survival time ratio in the DGA group was higher than that in the routine outpatient group (P<0.05), but no significant difference was observed in the total medical cost-filled tooth survival time ratio (P>0.05).

Conclusion

Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

Key words: severe early child caries, dental general anesthesia, survival analysis, cost, health economic

中图分类号:

R788

刘亚琪, 张琼, 王艳, 瞿星, 邹静. 重度低龄儿童龋儿童全身麻醉与常规门诊下牙病治疗的疗效及卫生经济学评价[J]. 华西口腔医学杂志, 2021, 39(6): 703-708.

Liu Yaqi, Zhang Qiong, Wang Yan, Qu Xing, Zou Jing. Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries[J]. West China Journal of Stomatology, 2021, 39(6): 703-708.

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组别	性别（n/%）		年龄/月	dmft	观察时间/月
组别	男	女	年龄/月	dmft	观察时间/月
DGA组	24/47.1	27/52.9	52.43±10.64	15.67±3.12	46（42，52）
常规门诊组	23/48.9	24/51.1	54.57±9.42	14.57±3.17	52（45，54）

组别	乳前牙			乳磨牙
组别	治疗总数/颗	计划外再治疗牙数/颗	计划外再治疗发生率/%	治疗总数/颗	计划外再治疗牙数/颗	计划外再治疗发生率/%
DGA组	363	125	34.44	371	106	28.57
常规门诊组	124	38	30.65	332	196	59.04

重度低龄儿童龋儿童全身麻醉与常规门诊下牙病治疗的疗效及卫生经济学评价

Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries

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