台大醫院牙科急診病例分析

Abstract

牙科急診在整個牙科醫療體系中有其重要性及其特殊性， 惟有關於急診病例的長期研究報告卻非常缺乏。先前之研究顯示牙髓疾病佔牙科急診診斷類別之最高比例。為明瞭牙科急診之情況及牙髓疾病在牙科急診中之狀況，本研究之第一部分為收集台大醫院自1991年1月至2000年12月十年間的牙科急診病例，共計7849人，8576人次，記錄並統計分析性別、年齡、診斷分類、主訴、居住地、就診時間、是否為新舊病患及是否回診等變項。第二部份再收集2005年1月至2005年12月一年間的台大牙科急診牙髓疾病病例，共計463人次，記錄並統計分析性別、年齡、主訴、全身性病史、患齒病史、臨床發現、患齒齒位、診斷分類、處置方式、就診前服藥與處置成效等變項。其研究結果顯示：1. 十年來，男性病患多於女性病患，年齡以20~29歲患者佔最大之比例，診斷以牙髓疾病居冠。 2. 十年來，每年人數有逐年增加之趨勢，大多數的病患都是舊病患，另外大多數的病患都沒有至本院回診的習慣。3. 牙髓疾病病患以急性牙髓炎為最多。4. 牙髓疾病患者大多覺得接受處置後症狀有改善（佔83.4％）。5.開立止痛藥、斷髓、拔髓及拔牙等處置對牙髓疾病求診之患者而言，其症狀緩解是有幫助的。藉上述十年來牙科急診病患特性、就醫型態改變、就診及回診的結果，希望能輔助牙科急診業務之實施。此外藉牙髓疾病急診分析的結果，提供患者更有效的治療方式。

Although there still were no long-term studies in this field have been performed in Taiwan, dental emergency play an essential role in dentistry. In previous studies, endodontic emergency has been purposed a major part of dental emergency. The goal of this study is to understand the basic patient information and behavior of visit and recall in dental emergency care during the past 10 years, and to find which factors affect the efficacy of treatment for endodontic emergency. Data for this retrospective study were collected from the dental emergency department of NTUH from January 1991 to December 2000 and endodontic emergencies from the dental emergency department of NTUH from January 2005 to December 2005. Data consists of a total of 8576 emergency visits from January 1991 to December 2000 and 463 endodontic emergency visits from January 2005 to December 2005. Statistical analyses were performed on variables, ex. gender, age, emergency type, chief complaint, resident, time of visit, patient type, recall or not, treatment, medication before visits and degree of complacence. The following results were obtained. (1) During the past 10-years, distribution of gender: male was larger than female; distribution of age: the largest group was between 20-29 y/o; distribution of diagnosis: the largest emergencies was for endodontic diseases. (2) During the past 10-years, there was an increase in dental emergency visits, the larger group was former patient, and the larger group would not have a subsequent visit. (3) The largest endodontic emergencies were for acute pulpitis. (4) The larger group of patients for endodontic emergencies thought symptoms were better after accepting treatment. (5) Analgesics, pulpotomy, pulpectomy, and extraction were seemed to have effect for improving symptoms. We hope these demographic results could enhance dental emergency services and improve medical care.