基于COM-B模型的口腔微环境管理在颈动脉内膜剥脱术的颈动脉狭窄合并牙周炎患者中的应用OA
Application of oral microenvironment management based on COM-B model in patients with carotid stenosis complicated with periodontitis undergoing carotid endarterectomy
目的:评价基于能力-机会-动机-行为(COM-B)模型的口腔微环境管理在颈动脉内膜剥脱术(CEA)的牙周炎患者中的应用效果.方法:采用前瞻性随机对照研究,选取2024年1月至2025年5月在南京鼓楼医院血管外科接受CEA的颈动脉狭窄合并牙周炎患者138例.所有患者均经院内智能评估流程判定为颈动脉斑块不稳定,采用随机数表法分为干预组和对照组,每组69例.对照组接受常规口腔健康教育及随访护理,干预组在此基础上实施基于COM-B模型的口腔微环境管理.比较两组入院时、出院时、术后3及6个月时的口腔健康素养量表得分,以及入院时和术后6个月时的牙菌斑指数、牙龈指数和龈沟出血指数.结果:术后6个月,干预组口腔健康素养量表得分(165.29±23.63)分,高于对照组的(150.97±21.86)分,差异有统计学意义(t=3.694,P＜0.001);干预组入院时、出院时、术后3及6个月时的得分比较,差异有统计学意义(F=54.561,P＜0.001),对照组入院、出院及术后3和6个月4个时间点比较,差异无统计学意义(P＞0.05).术后6个月,干预组牙菌斑指数、牙龈指数和龈沟出血指数均低于对照组,差异均有统计学意义(t=-3.510、-3.510、-4.789,P＜0.05).结论:基于COM-B模型的口腔微环境管理可提高接受CEA的牙周炎患者的颈动脉狭窄合并口腔健康素养,并改善牙菌斑、牙龈及龈沟出血状况.
Objective:To evaluate application effects of management based on the capability,opportunity,motivation-behavior(COM-B)model for oral microenvironment in patients with periodontitis,who underwent carotid endarterectomy(CEA).Methods:The prospective randomized controlled study was adopted,and a total of 138 patients with carotid stenosis and periodontitis,who underwent CEA at the Department of Vascular Surgery of The Affiliated Drum Tower Hospital between January 2024 and May 2025,were selected.All patients were judged as unstable carotid plaques through intelligent assessment workflow of hospital,and this result only was used to define population of study.Patients were divided into an intervention group and a control group by using random number table,with 69 patients in each group.The control group received routine oral health education and follow-up care,while the intervention group additionally received COM-B model-based management for oral microenvironment on the basis of the method of control group.The scores of oral health literacy scale of two groups were compared at admission,discharge,and at the 3rd and 6th month after surgery.In addition,the dental plaque index,gingival index,and gingival bleeding index of two groups were also compared at admission and at the 6th month after surgery.Results:At the 6th month after surgery,the score(165.29±23.63)of oral health literacy scale of intervention group was higher than that(150.97±21.86)of control group,and the difference was significant(t=3.694,P<0.001).The difference of the scores of intervention group was significant among admission,discharge,at the 3rd month,and at 6th month after surgery(F=54.561,P<0.001),but there was no significant difference at the scores of control group among the above four time points(P>0.05).At the 6th month after surgery,the dental plaque index,gingival index,and gingival bleeding index of intervention group were lower than those of control group,and the differences were significant(t=-3.510,-3.510,-4.789,P<0.05).Conclusion:COM-B model-based management for oral microenvironment can improve oral health literacy of patients with periodontitis who undergo CEA,and can improve the situation of dental plaque,gingiva,and gingival bleeding.
周艳;乔彤;翁艳敏;赵梦扬
南京大学医学院附属鼓楼医院血管外科 南京 210008南京大学医学院附属鼓楼医院血管外科 南京 210008南京大学医学院附属鼓楼医院血管外科 南京 210008南京大学医学院附属鼓楼医院血管外科 南京 210008
医药卫生
能力-机会-动机-行为(COM-B)模型口腔微环境管理颈动脉内膜剥脱术(CEA)牙周炎口腔健康素养
Capability,opportunity,motivation-behavior model(COM-B)Management for oral microenvironmentCarotid endarterectomy(CEA)PeriodontitisOral health literacy
《中国医学装备》 2026 (9)
33-36,43,5
南京中医药大学自然科学基金项目(XZR2023016)南京大学中国医院改革发展研究院项目(NDYGN2024073) This work was supported by the Natural Science Foundation of Nanjing University of Chinese Medicine(XZR2023016)The China Hospital Reform and Development Research Institute,Nanjing University(NDYGN2024073)
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