错畸形对儿童口腔健康相关生活质量影响的研究

宿洪丽 彭谦

宿洪丽 彭谦

错牙合畸形； 口腔健康相关生活质量； 儿童； 家长

1 资料与方法

1.1 选择对象

1.2 方法与测量工具

表 1 不同DHC儿童的OHRQoL

将英文量表翻译成中文，然后回译确保中文版本的准确性和一致性。调查前选择20 对其他原因就诊的儿童和家长预测试，校正可能造成误解的语句。调查者向家长和儿童解释研究目的和方法后分别独立填写调查表。儿童采用“1=是”/“0=否”2 种回答；家长采用likert量表计分(1=偶尔，2=经常，3=很频繁)来表示儿童受影响的程度。

1.2.3 收集家长的社会学资料 根据父母受教育程度分组为高中以下(L)、高中(M)、大学及以上(H)；根据家庭收入分为低(L)、中等(M)、高收入(H)。

1.3 统计学分析

根据调查结果计算DHC和M-OHRQOL的分值。采用SPSS 10.0版本统计软件进行统计学分析。采用卡方检验比较DHC和M-OHRQoL关系；采用组内相关系数(ICC)分析儿童和家长生活质量的相关性；校正后的比数比(OR)及95%可信区间(CI)用于分析比较不同组间的生活质量影响。所有统计结果以0.05为标准检验是否有统计学差异。

2 结 果

本研究共调查118 名口腔正畸门诊就诊儿童，25(21.2%)名DHC结果不需要正畸治疗，30 名(25.4%)处于临界，63 名(53.3%)需要治疗。在咀嚼困难、不喜欢牙齿、影响微笑和同伴取笑方面有受影响(表 1)。家长认为在影响咀嚼和学习成绩方面对OHRQoL有影响(表 2)。控制社会学因素的多元逻辑回归分析：家长学历低、收入低的儿童OHRQoL受影响大；高学历、低收入、男孩的家长受影响大(表 3)。

表 2 不同DHC家长的OHRQoL值

Tab 2 OHRQoL of the children evaluated by the parents with different DHC

问 题DHC从来没有偶尔经常P值影响咀嚼G137.534.228.30.038G2/G319.227.753.1影响学习成绩G119.130.850.10.014G2/G310.711.777.6孩子对牙齿很满意G161.530.87.70.454G2/G361.722.316.0孩子有抱怨牙齿不好看G123.126.950.00.580G2/G316.023.460.6

表 3 儿童、家长与OHRQoL相关的多元逻辑回归分析

注： 不同相关因素间的比较,P<0.05

3 讨 论

3.1 错牙合畸形对OHRQoL的影响

3.2 影响的相关因素

3.3 不足及展望

本研究的研究对象是临床患者，其结果不适用于普通人群。尽管目前对OHRQoL的测量涵盖了口腔健康、功能和社会心理方面，但不能完全代替临床客观资料评价。家长和儿童的意见反映了他们的正畸治疗需求，制定临床治疗计划和评价治疗结果时考虑这些因素，可以弥补医生单纯依靠临床资料的偏差，更好地满足患者需求，这也正是现代正畸治疗追求的目标。但目前各研究结果报道尚存差异，评价OHRQoL仍需从测量工具、方法和参数的界定等方面统一标准，才能真正成为辅助临床治疗的主观测量工具。

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Asessmentoftheimpactsofmalocclusiononthechildrensoralhealthrelatedqualityoflife

SUHongli，PENGQian.

261053，DepartmentofStomatology,TheAffiliatedHospitalofWeifangMeidcalUniversity，China

Objective: To study the impacts of malocclusion on the oral health-related quality of life(OHRQoL) of children.MethodsThe study sample comprised 118 children seeking orthodontic treatment.Each participant of the children and parents was assessed by the orthodontic treatment need and OHRQoL using the index of orthodontic treatment need and Michigan-OHRQoL.ResultsThe objective impacts of the teeth to parents and children were consistent; parents evaluated higher than the children themselves in the subjective impacts of their teeth.The impacts were more influential on the children whose parents with higher income and the parents with higher education.ConclusionMalocclusion affects the oral health related quality of life evaluated by both the children and their parents.

Malocclusion;Oralhealthrelatedqulityoflife;Children;Parents

261053， 潍坊医学院附属医院口腔科

宿洪丽 E-mail: orthohongli@hotmail.com

R783.5

A

10.3969/j.issn.1001-3733.2017.04.015

(收稿： 2016-10-22 修回： 2017-04-25)