全麻下牙科治疗对儿童口腔健康相关生活质量的影响：一项综合性荟萃分析
贵州医科大学 麻醉与心脏电生理课题组
翻译：赵游霄 编辑：赵游霄 审校：曹莹
背景：儿童的口腔健康对其整体健康、日常活动以及社交互动有着显著影响。对于广泛存在的口腔问题、特殊医疗需求或牙科恐惧症，尤其是儿童群体，通常需要在全身麻醉下进行牙科治疗。本荟萃分析旨在系统地回顾和综合现有研究，探讨全身麻醉下的牙科治疗如何影响儿童的口腔健康相关生活质量（OHRQoL）。
方法：按照 PRISMA 指南，对 PubMed、EMBASE、Ovid MEDLINE、Web of Science 和 Scopus 等电子数据库进行了系统检索，以确定评估全身麻醉下牙科治疗后口腔健康相关生活质量（OHRQoL）变化的研究。纳入了在术前和术后评估中使用 ECOHIS 和 COHRQoL 量表的研究。全身麻醉下牙科治疗前后量表测量的平均差异以标准平均差（SMD）报告，Hedges’g 效应量分类如下：小效应（0.2）、中效应（0.5）、大效应（0.8）。所有荟萃分析的统计计算均使用随机效应模型的 Hartung-Knapp-Sidik-Jonkman 方法进行。
结果：共有 36 篇论文符合纳入标准，并随后被纳入此次研究。在汇总分析中，儿童在全身麻醉下的治疗在短期内显著改善了口腔健康相关生活质量（ECOHIS），效应量较大（标准化均数差 = 1.66，95% 置信区间：1.07 – 2.24，p < 0.001；τ2 = 2.18，I2 = 98.9，p < 0.001）。同样，全身麻醉下的牙科治疗显著提高了儿童的儿童口腔健康相关生活质量（COHRQoL）评分，效应量较大（标准化均数差 = 1.32，95% 置信区间：0.81 – 1.84，p < 0.001；τ2 = 0.78，I2 = 97.3，p < 0.001）。
结论：这项荟萃分析的结果表明，有证据显示，在接受全身麻醉进行牙科治疗的儿童中，其口腔健康相关生活质量在治疗后的短期内有所改善，且改善效果显著。
原始文献：
Yilmaz N A, Arayici M E, Efeoglu C. Impact of dental treatments under general anesthesia on oral health-related quality of life in children: a comprehensive meta-analysis [J]. BMC Oral Health, 2025, 25(1).
Impact of dental treatments under general anesthesia on oral health-related quality of life in children: a comprehensive meta-analysis
Abstract
Background
Children’s oral health significantly impacts their overall well-being, daily activities, and social interactions. Dental treatments under general anesthesia are often required for extensive dental problems, special health care needs, or dental phobias, particularly in pediatric populations. The objective of this meta-analysis was to systematically review and synthesize existing research on how dental treatments under general anesthesia affect the oral health-related quality of life (OHRQoL) in children.
Methods
The electronic databases such as PubMed, EMBASE, Ovid MEDLINE, Web of Science, and Scopus were systematically reviewed following PRISMA guidelines to identify studies evaluating OHRQoL changes after dental treatments under general anesthesia. Studies involving ECOHIS and COHRQoL scales in pre- and postoperative assessments were included. The mean differences between scale measurements before and after dental treatments under general anesthesia were reported as the standard mean difference (SMD), and effect sizes for Hedges’g were classified as follows: small effect (0.2), medium effect (0.5), large effect (0.8). All meta-analysis statistical computation was carried out using the Hartung-Knapp-Sidik-Jonkman method for the random effects model.
Results
A total of 36 papers satisfied the inclusion criteria and were subsequently included in the investigation. In the pooled analysis, treatments under general anesthesia in children improved OHRQoL (ECOHIS) in the short term with a significantly large effect size (SMD = 1.66, 95% CI: 1.07–2.24, p < 0.001; τ2 = 2.18, I2 = 98.9, p < 0.001). Similarly, dental treatment under general anesthesia increased the COHRQoL score in children with a significantly large effect size (SMD = 1.32, 95% CI: 0.81–1.84, p < 0.001; τ2 = 0.78, I2 = 97.3, p < 0.001).
Conclusions
The findings of this meta-analysis suggest that there was evidence that OHRQoL of children receiving dental treatment under general anesthesia improves with a large effect size in the short-term following treatment.
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