国际口腔医学杂志

国际口腔医学杂志 ›› 2026, Vol. 53 ›› Issue (4): 465-475.doi: 10.7518/gjkq.2026617

• 专家笔谈 • 上一篇    下一篇

儿童口腔舒适化诊疗的行为管理策略

刘奕(),杜芹()   

  1. 四川省医学科学院·四川省人民医院（电子科技大学附属医院）口腔医学中心 成都 610072
  • 收稿日期:2025-11-21 修回日期:2026-04-15 出版日期:2026-07-01 发布日期:2026-06-25
  • 通讯作者: 杜芹
  • 作者简介:刘奕，电子科技大学·四川省人民医院口腔医学中心主任医师，电子科技大学医学院教授，博士，硕士研究生导师。四川省口腔医学会镇静镇痛专业委员会副主任委员，四川省口腔医学会儿童口腔医学专业委员会常务委员，四川省卫生健康委员会学术技术带头人后备人选，四川省海外高层次留学人才。主要从事儿童口腔医学的临床、教学、科研等工作。发表学术论文30余篇，主持国家级、省市级和院级科研项目6项，副主编论著1部。|刘奕，主任医师，博士，Email：liuyikq@med.uestc.edu.cn|杜芹，电子科技大学·四川省人民医院口腔医学中心主任医师，副主任，口腔医学博士，硕士研究生导师，四川省海外高层次留学人才，四川省学术技术带头人后备人选，四川省卫生健康委员会学术带头人后备人选。中华口腔医学会儿童口腔医学专业委员会委员，中华口腔医学会镇静镇痛专业委员会委员，四川省口腔医学会理事，四川省口腔医学会儿童口腔医学专业委员会副主任委员，四川省口腔医学会医学教育专业委员会副主任委员。主要从事儿童口腔医学的临床、教学、科研等工作。发表学术论文30余篇，主持国家级、省市级和院级科研项目11项，主编/参编论著5部。
  • 基金资助:
    四川省自然科学基金(2026NSFSC0686);四川省医学科学院·四川省人民医院科研基金(2022QN30)

Comfortable dental treatment for children: behavior management strategies

Yi Liu(),Qin Du()   

  1. Center of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu 610072, China
  • Received:2025-11-21 Revised:2026-04-15 Online:2026-07-01 Published:2026-06-25
  • Contact: Qin Du
  • Supported by:
    Natural Science Foundation of Sichuan Province(2026NSFSC0686);Scientific Research Foundation of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital(2022QN30)

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摘要：

儿童在口腔诊疗过程中的不配合行为，不仅影响治疗质量和效率，还对其未来的口腔健康行为产生负面影响。随着口腔医学的快速发展，儿童口腔舒适化诊疗技术逐渐受到广泛关注，其通过行为管理、药物镇静和无痛技术等方法，减轻患儿的恐惧和疼痛感，提高治疗配合度，改善诊疗体验。本文系统梳理儿童口腔舒适化诊疗从基础理论到临床应用的研究，探讨非药物性行为管理技术、药物镇静、全身麻醉技术等行为管理策略的进展和应用效果。

关键词: 儿童口腔医学, 行为管理, 舒适化诊疗, 数字化

Abstract:

The rapid development of stomatology and the continuous improvement of patients' medical needs have led to a notable focus on comfortable dental treatment techniques. During dental treatment, children often exhibit anxiety and uncooperative behaviors due to factors such as pain during treatment, incomplete cognitive development, and fear of unfamiliar environments. This not only influences the quality and efficiency of treatment but may also have long-term negative effects on their future oral health behaviors. Comfortable dental treatment technology aims to reduce children's fear and pain, improve treatment compliance, and enhance the diagnostic and treatment experience through methods such as behavior management, drug sedation, and painless technology. This paper systematically organizes relevant studies on comfortable dental treatment for children at multiple levels from basic theoretical research to clinical application. It emphasizes the latest advancements and efficacy of non-pharmacological behavior management technologies, drug sedation and anesthesia technologies, and digital and artificial intelligence-assisted technologies.

Key words: pediatric dentistry, behavior management, comfort treatment, digitalization

中图分类号: 

  • R788

表 1

儿童口腔常用的局部麻醉药物"

药物类型药物名称浓度及剂型特点最大推荐剂量
酰胺类利多卡因2%注射液应用广泛，用于浸润麻醉及阻滞麻醉4.4 mg/kg
2%、5%软膏或凝胶性能稳定，起效快，用于表面麻醉4.4 mg/kg
甲哌卡因2%注射液+1∶100 000肾上腺素；3%注射液（不含肾上腺素）pH值较高，局部组织有感染时的最佳选择，依据所需麻醉时间选择是否含肾上腺素4.4 mg/kg
阿替卡因4%注射液毒性相对较小，浸润效力强，4岁以下不推荐7 mg/kg
复方利多卡因2.5%利多卡因和2.5%丙胺卡因，乳膏镇痛效果优于单一麻药，但口感欠佳避免过量
酯类苯佐卡因20%凝胶起效快、作用时间短，不适用于患有高铁血红蛋白血症的患者，2岁以下不推荐避免过量
丁卡因2%~4%凝胶表面麻醉时作用强度较高，毒性较高避免过量
西他卡因14%苯佐卡因+2%氨苯丁酯+2%盐酸丁卡因，喷雾具有苯佐卡因的快速起效与丁卡因的深层麻醉作用避免过量
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